(NaturalHealth365) From the prestigious New England Journal of Medicine to media outlets like the New York Times, Washington Post, and USA Today, news is rampant about ventilator shortages in the United States as hospitals around the country care for critically ill patients with COVID-19.

And it’s not just ventilators – there are also reported concerns about a shortage of healthcare providers who are trained to manage ventilated patients, plus a shortage of drugs required for ventilator use, including sedatives, painkillers, and paralytics.

But some health experts are starting to ask: is the use of a ventilator truly evidence-based in the fight against COVID-19?  Are these breathing machines – intended to help reverse low blood oxygen levels (hypoxia) – actually helpful, or could they be causing unnecessary lung damage?

In other words, could less invasive interventions be more effective at restoring healthy lungs?

Are ventilators doing more harm than good? NYC critical care physician urges medical professionals to reconsider use of these machines for COVID-19 patients

A ventilator is a medical machine that helps a person breathe and ensures enough oxygen gets into the person’s blood, cells, tissues, and organs. Depending on the settings used (and on the needs of the patient), a ventilator may take partial or complete control over a person’s breathing by putting pressure on the lungs to help open up the small air-filled sacs inside (alveoli).

The machine features tubes which are attached to a person’s airway via a tightly fitted mask or a tube inserted down the patient’s throat.

The novel coronavirus, SARS-CoV-2, is believed to attack healthy lungs and render them ineffective at transferring oxygen from the lungs into the blood. This is thought to trigger respiratory failure conditions including pneumonia (lung infection) and acute respiratory distress syndrome (ARDS).

Traditionally, severe cases of pneumonia and ARDS are managed with mechanical ventilation. As a result, many doctors are prescribing ventilator use for critically ill COVID-19 patients. But one NYC physician, Dr. Cameron Kyle-Sidell, recently called this practice into question.

Dr. Kyle-Sidell is an emergency and critical care doctor with the Maimonides Medical Center in Brooklyn. In an April 6 video interview held with WebMD’s chief medical officer, he states that data shows about 70 percent of mechanically-ventilated COVID-19 patients are dying.  “That’s a very, very high percentage,” Dr. Kyle-Sidell notes, while adding that COVID-19 patients in his care are “unlike any patients I’ve ever seen.”

He wonders: could it be that ventilation protocol simply isn’t appropriate – or at worst directly harmful – for people infected with this pandemic disease?

COVID-19 does NOT appear to be the typical respiratory illness – so why is it being managed that way?

On March 31, 2020, Dr. Kyle-Sidell’s uploaded a video to his YouTube channel (see below) where he discussed his clinical thoughts regarding COVID-19 and mechanical ventilation.

Here are a few of his main talking points from this video (as well as his more recent interview with WebMD’s chief medical officer):

• Dr. Kyle-Sidell’s COVID-19 patients are presenting so unlike people with ARDS and pneumonia that he suspects these patients are dealing with something else altogether. After looking to data from other countries, Dr. Kyle-Sidell believes that severely ill COVID-19 patients “clinically…look a lot more like high-altitude sickness than they do pneumonia” or ARDS.
• You read that right – severely ill COVID-19 patients are presenting like people suffering from altitude sickness, otherwise known as “the bends.”   These patients look like they were “dropped off on the top of Mt. Everest without time to acclimate,” he states.
• He goes on to suggest that severely ill COVID-19 patients are not suffering from respiratory failure (at least not initially) but rather severe oxygen starvation.  Unfortunately, the high amount of pressure that mechanical ventilation imposes on these patients’ lungs could indeed be causing ARDS after the fact.
• Dr. Kyle-Sidell summarizes that the “viral-induced disease” is indeed taking people to the brink of death in some cases, but not in the way traditionally seen in pneumonia or ARDS. He warns that this is why COVID-19 “should not be treated” as a conventional respiratory illness.

In addition, ventilators may be problematic for more than just ventilated patients – these machines also put medical providers at increased risk of infection, too, since the devices can aerosolize infectious droplets.  Given that many hospitals are struggling with a lack of appropriate personal protective equipment (PPE), this raises serious concern for frontline workers.

Dr. Kyle-Sidell has been met with a lot of resistance in his practice setting, and time has yet to tell whether COVID-19 treatment protocols for severely ill individuals will change. In the meantime, oyxgen therapy via nasal cannuli or face masks have been shown to be effective for people suffering from COVID-19, at least before a patient’s severity progresses.

Hopefully, healthcare providers will use their best judgement and evidence-based decision-making to avoid unnecessary intubations.

Watch Dr. Kyle-Sidell’s video below:

NEJM.org
NYtimes.com
Washingtonpost.com
USAtoday.com
UPI.com
CDC.gov
WIFR.com
AgingCare.com
Medscape.com
ATSjournals.org