High mortality from mechanical ventilation – naturopathy & naturopathic specialist portal

Is intubation the right treatment for COVID-19?

Mechanical ventilation (intubation) is the last resort to rescue seriously ill COVID-19 sufferers. However, two studies already show that the mortality rate is unusually high with such treatment. Around half of the patients died in England and two thirds in China who received mechanical ventilation as a result of COVID-19. The risk of death is thus far higher than the ventilation that is carried out as a result of other viral diseases.

The Intensive Care National Audit and Research Center (ICNARC) recently published a report evaluating data from 2,883 people with severe COVID-19 courses. All patients were treated in an intensive care unit in Great Britain. It was found that the mortality rate for those receiving artificial ventilation was 51.6 percent – much higher than for other viral pneumonia. The “ICNARC report on COVID-19 in critical care” can be viewed on the ICNARC website.

Ventilation death rates are higher than usual for COVID-19

Mechanical ventilation (intubation) is also used for severe courses of other viral diseases, such as influenza, if there is pneumonia. The average 30-day mortality rate from such treatment is 22 percent, according to the ICNARC. Around four out of five affected people survive such treatment.

Around every second person dies from artificial ventilation

The latest ICNARC report shows that in 1689 intubations completed due to severe COVID-19 disease, 871 people died and 818 were released alive. That gives a 30-day mortality rate of 51.6 percent in this group. An even more drastic picture is a smaller case series from Wuhan. Here, 32 out of 52 patients died in the intensive care unit. This results in a mortality rate of 62.5 percent.

Age as the most important risk factor

The chances of survival are much better for those who do not need intubation. Here, the death rate was 19.4 percent – significantly lower than with mechanical ventilation. The most important factor for the survival of the difficult courses is the age. Only 27.1 percent of patients over the age of 80 survived ventilation. Of those aged 70 to 79, 31.3 percent survived. In the 60 to 69 age group, 43.6 percent of those affected were released live and 58.9 percent of the 50 to 59 year olds.

Alternatives to mechanical ventilation

The results indicate that the treatment of severe courses needs to be improved. For example, a small Chinese study showed that the prone position improves breathing in severe COVID-19 diseases.

According to various media reports from the USA, many doctors are switching to alternative methods due to the high mortality rate in mechanical ventilation. This should make breathing easier and relieve the lungs through changes in position. In addition, some doctors try to deliver larger amounts of oxygen through the nose, sometimes with the addition of nitrogen monoxide. There is currently no reliable data on whether such methods are more effective. (vb)