Ventilator use declines as doctors get a better understanding of COVID-19

HONOLULU, Hawaii (HawaiiNewsNow) - Just seven months ago, COVID-19 didn’t exist. So, in many ways treating the virus has been an experiment — trying to figure out what works and what doesn’t.

Doctors say one of the biggest changes has to do with ventilators. Before, patients were being placed on the breathing machines early-on.

Now, they’re being used as a last resort.

Monday’s update on hospital resources highlights the shift.

“53 out of our 459 ventilators are in use right now,” said Lt. Gov. Josh Green. “But only two of those ventilators that are in use are for COVID positive individuals.”

The Chief of Critical Care at Kaiser Moanalua Medical Center told HNN, “We’re really now trying to keep patients off the ventilator as long as we can.”

Dr. Sree Krishnagopalan says even patients who are very sick can often beat the virus without a ventilator, adding the machine can sometimes prolong recovery.

“It seems to take even longer for them to get better,” he said. “They’re often immobilized so they get weaker. The rehab and all the physical deconditioning takes a toll on the body as well.”

He says providing patients with high concentrations of oxygen can help keep them off of a ventilator. Getting them to lie on their stomach in what’s called the “prone position” can help, too.

“It has to do with the distribution of blood and air in their lungs,” said Krishnagopalan. “We don’t quite understand everything that’s going on in the process but we know that it works.”

When it comes to medication, some doctors have started prescribing blood thinners.

“One thing that this virus does is cause sometimes rampant clotting throughout the body,” said Krishnagopalan. “There are lots of reports of patients getting better from the virus and the pulmonary and lung symptoms — but then succumbing to clots, either strokes or heart attacks.”

Meanwhile, there’s evidence the anti-viral drug remdesivir seems to help shorten the course of the illness, while a steroid called dexamethasone has been shown to help some of the sickest patients beat the virus.

As doctors get a better understanding of COVID-19, Krishnagopalan says they’re starting to feel a little more confident in what they’re doing.

“It does seem that the mortality is getting better overall,” he said. “Not just with us. But as all of us around the world learning to deal with and treat the disease.”

The doctor urges folks to do everything they can to stay healthy. He says washing your hands and wearing a mask are still two of the best ways to keep from getting sick.

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