LSU doctors use a non-invasive ventilation method to help COVID-19 patients breathe
NEW ORLEANS, La. (WVUE) -COVID-19 has proven it can be lethal and traditional ventilators are a critical weapon in keeping many patients alive. But some LSU doctors are pressing the pause button on immediately turning to ventilators to treat seriously ill coronavirus patients and they are seeing good results.
Dr. Kyle Happel is part of the LSU Health Pulmonary/Critical Care Medicine team.
"Certainly, mechanical ventilation is the traditional route of supporting people who have a respiratory failure in the hospital in the ICU. They can achieve great results when used properly and indeed many folks who have COVID-19 are appropriately on the mechanical ventilator,” Happel said.
Ventilators involve placing a tube down a patient’s throat and sedation. Happel said he and some of his colleagues wanted to achieve the same life-saving results without using the invasive machine.
“The concern that we had I think very early on in the COVID outbreak when the LSU Health Sciences Center Pulmonary Critical Care group, several of us wanted to see if we could achieve some of the same benefits of mechanical ventilation with the endotracheal tube that we could perhaps do with a non-invasive ventilator, avoid going on the ventilator, avoid the endotracheal tube and try to see some of the benefits that we’ve seen with that tragedy that have existed even before COVID,” Happel said.
Happel said patients are doing well with the innovative method they are using.
“Well, what we’ve found so far is that individuals are tolerating the non-invasive ventilation fairly well,” he said.
Still, he admits it took being creative, literally.
"What we've been able to do is to actually sort of assemble some components to be able to make a non-invasive ventilator circuit that filters both the air going as well as filters the air coming out of the patient into the atmosphere. These are viral filters that filter out 99.2 percent of all viral particles, so that the air coming out of the patient from the non-invasive mask is not the risk that it would be traditionally with non-invasive ventilation,” Happel stated.
The American Lung Association champions using other procedures when it is in the patients’ best interests.
"We’re trying to keep the ventilators the last choice. The ventilators are great because of the role the ventilator is actually to support our lungs until our body heals the injury that it has succumbed to,” Dr. Rabih Bechara said, the national spokesman for the American Lung Association, who is also a professor of medicine in Georgia.
He said traditional ventilators are very useful in some situations.
"Ventilators are good and ventilators are bad, too, because patients can also have something that we call ventilator-associated lung injury and patients who are on a ventilator for a long time can also develop lung infections in addition to what they also have,” Bechara said.
Happel said at LSU they embraced existing evidence related to ventilators.
"Before COVID, there was great evidence that particularly for people that have chronic lung disease or even chronic heart disease the use of non-invasive ventilation as opposed to traditional intubation and invasive mechanical ventilation carries, in many cases, a survival benefit,” he said.
Bechara said the odds of complications increase when patients are on ventilators for a long time.
"Patients who are usually on ventilators for a prolonged period of time are pre-disposed to complications from that machine itself,” he said.
And at LSU Health, doctors like Happel are working on even more innovative procedures. "We probably have another mouse trap designed every few days, so the one that I’m showing you now this is the latest iteration, it’s a little bit different than what we first started using,” Happel said.
Governor John Bel Edwards said the innovations are reducing the number of people on ventilators in the state.
“The reason we’re seeing fewer people on vents is because of efforts being made by healthcare professionals, doctors and others in our hospitals to treat people differently,” said Edwards during a press briefing this week.
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