A paper recently published by The American Society of Tropical Medicine and Hygiene adds further support to recent CDC guidelines for minimizing the use of invasive ventilators. As physicians had been voicing concern that doctors were being too eager to put patients on invasive ventilation and may be doing more harm than good, the investigators looked into outcomes of intubated patients vs. non-intubated patients experiencing hypoxia. Unlike with other forms of pneumonia, they found that COVID-19 patients were unusually damaged by invasive ventilation but also able to tolerate higher levels of anoxia — to the point that one doctor recalls having to tell patients to get off their cellphones so that they could be intubated. The recommendation is that guidelines be adjusted to discourage invasive ventilation unless a patient is physically struggling to breathe, rather than relying strictly on oxygen levels; otherwise, the use of non-invasive ventilation, such as CPAP and BiPAP, should be encouraged. When invasive ventilation is used, oxygen levels should be minimized in order to reduce the risk of damaging healthy tissue.



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