COVID-19: Ventilators no more first choice, doctors prefer oxygen therapy for critical patients

High flow oxygen therapy— in which patients are given oxygen at the rate of about 60 litre per minute coupled with lying on the stomach by patients — has emerged as a preferred procedure.
A health worker takes a nasal swab sample for COVID- 19 testing through rapid antigen methodology in New Delhi on Friday. (Photo | Shekhar Yadav/EPS)
A health worker takes a nasal swab sample for COVID- 19 testing through rapid antigen methodology in New Delhi on Friday. (Photo | Shekhar Yadav/EPS)

NEW DELHI:  Over the last few months, hospitals have changed the way they are treating very Covid-19 patients.

Early in the pandemic, there was almost a rush to put patients with dangerously low oxygen levels on ventilators but nearly six months into the pandemic, doctors have learnt that it does not work—mostly.

Instead, a lesser known method of treatment for ICU patients with acute respiratory distress syndrome, has taken the centrestage.

High flow oxygen therapy— in which patients are given oxygen at the rate of about 60 litre per minute coupled with lying on the stomach by patients — has emerged as a preferred procedure for ICU patients.

No wonder that domestic manufacturers are struggling to find takers in both government and private sectors.

With just about 40,000 ventilators, the unavailability of the crucial medical device was anticipated to be a major impediment in the fight against the disease. 

As part of the Central aid about 18,000 low cost ‘Made In India’ ventilators have been already provided to the states. But, as it turns out, for most part they have not even been used, say sources as the understanding about the disease has changed.

Critical care specialists, this newspaper spoke with, said that initially it was thought that in the worst case scenario, Covid-19 leads to severe pneumonia in some patients.

“We used to avoid non-invasive ventilation and high flow oxygen fearing it would increase the risk to healthcare workers,” said Dr Dipak Govil, a critical care specialist in Medanta hospital in Gurugram.

As per the data released by the Health Ministry, less than 0.3% of the active cases were on ventilator.

“We are learning on the go and seem to be getting better in managing ICU patients without ventilators,” said Dr Dhruva Chowdhary, an intensivist in PGI, Rohtak.

Another ICU doctor in Mumbai said, “There was a research from New York which showed that up to 80% of the patients on ventilators did not recover and that particular paper kind of prompted doctors pin hopes on oxygen therapy.”

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