I spent 5 months on a ventilator, Ecmo and a dialysis machine due to covid pneumonia. I had internal bleeding among other problems and was only given a 3% chance of living. Coming off Ecmo was one of the hardest things I've ever had to do. It saved my life but left me handicapped, i have severe nerve damage to my right leg and foot.
Reply given by Dr. Christopher Voscopoulos: In general when it comes to COVID-19 what we are commonly seeing is patients going between HFNC and Bipap for weeks to months. In doing so, especially with Bipap, the risk these patients face is lung damage from stretch injury, so called self induced lung injury, largely when tidal volumes are greater than 9cc/kg. In terms of mechanical ventilation lung damage can also occur through a variety of mechanisms. Broadly speaking the longer a patient is mechanically ventilated the higher the chances of lung damage occurring. One of the premises of ECMO is to rest the lungs by, in essence, not using them or using them only extremely minimally on so called rest settings. Because of this concept the generally accepted practice pattern is to consider placing patients on ECMO early before lung damage occurs. On the converse of this, many critical care doctors have successfully managed COVID-19 hypoxemia below a P/F ratio of 60 without mechanical ventilation or ECMO. So, I would humbly say the answer to your question is that we just haven't had an opportunity to learn more about how best to manage COVID-19 respiratory failure. As such I would encourage all critical care practitioners keep the principles in mind above but to heavily rely on your clinical judgment until we have more experience and data to collectively learn from and create generally accepted standards of care.
I've seen many cases of ecmo treatment with covid patients. The sooner ecmo inserted, the better patient's outcome we would have. Covid-ARDS-Sepsis process is very fast. So it's better to decide ecmo treatment as soon as possbile with consideration of patient's condition.
How stupid and nuremberg y’all are. covid19 is a non-respiratory failure coronavirus infection that became a democracy hospitalization genocide propaganda for money.
@@MedicalSpecialistsAssociates How stupid and nuremberg y’all are. covid19 is a non-respiratory failure coronavirus infection that became a democracy hospitalization genocide propaganda for money.
@@greatworld502 How stupid and nuremberg y’all are. covid19 is a non-respiratory failure coronavirus infection that became a democracy hospitalization genocide propaganda for money.
