Coro­n­avirus in­ten­sive care; what’s in­volved?

Kuwait Times - - In­ter­na­tional -

PARIS: The coro­n­avirus pan­demic has caused many thou­sands of peo­ple, in­clud­ing Bri­tain’s prime min­is­ter, to need treat­ment in in­ten­sive care units, where se­vere cases of COVID-19 of­ten re­ceive breath­ing sup­port. Boris John­son was moved into in­ten­sive care when his con­di­tion wors­ened on Mon­day, 10 days af­ter di­ag­no­sis-a typ­i­cal pro­gres­sion as the virus be­gins to at­tack the lungs, re­duc­ing the amount of oxy­gen go­ing to the body and its vi­tal or­gans. Fail­ure to at least halt COVID-19 will lead to or­gan fail­ure and death but keep the pa­tient alive long enough, and they stand a chance of over­com­ing it and pulling through. Here is a sum­mary of what is in­volved in in­ten­sive care treat­ment:

Who ends up in in­ten­sive care?

Life sup­port is re­served for pa­tients suf­fer­ing from se­vere res­pi­ra­tory fail­ure re­sult­ing from the lungs be­ing af­fected by the virus. The World Health Or­ga­ni­za­tion (WHO) es­ti­mated at the end of Fe­bru­ary that in China some 20 per­cent of in­fec­tions re­sulted in se­vere cases - 6.1 per­cent who were crit­i­cal, as well as 13.8 per­cent deemed se­vere.

Ad­mis­sion de­pends on the se­ri­ous­ness of the symp­toms-as well as the avail­abil­ity of beds. In Italy, a March es­ti­mate put the num­ber of con­firmed cases re­quir­ing in­ten­sive care at 12 per­cent. So far in coun­tries

that have had out­breaks, fig­ures show that the vast ma­jor­ity of se­ri­ous cases are in men. Bri­tish data from 2,621 pa­tient ad­mis­sions to in­ten­sive care up to April 3, showed that 73 per­cent were men, with an av­er­age age of 60.

“It is be­com­ing in­creas­ingly rec­og­nized that there are sub­stan­tial difference­s in the im­mune sys­tem be­tween males and fe­males and that these have sig­nif­i­cant im­pact on out­come from a wide range of in­fec­tious dis­eases,” said Philip Goul­der, Pro­fes­sor of Im­munol­ogy in the De­part­ment of Pae­di­atrics at the Univer­sity of Oxford. He said life­style and so­cial factors could also be in­volved, in­clud­ing smok­ing “which af­fect the level of pre-ex­ist­ing dis­ease such as heart dis­ease, chronic lung dis­ease and cancer.”

What is in­volved?

The guid­ing prin­ci­ple of in­ten­sive care is to help pa­tients whose vi­tal or­gans-heart, lungs, kid­neys-are at risk and need im­me­di­ate and con­stant help. In COVID-19 cases, it is the lungs which come un­der at­tack, with pa­tients strug­gling to get enough oxy­gen, of­ten de­te­ri­o­rat­ing very quickly as a re­sult.

This de­te­ri­o­ra­tion “can hap­pen very quickly be­tween the eighth and tenth day of the ill­ness, of­ten in the space of just a few hours,” Dr Al­brice Levrat, head of in­ten­sive care in the east­ern French city, ex­plained to Le Point weekly. In the first in­stance, the pa­tient is given oxy­gen through tubes to the nose, pro­gress­ing to a pres­sur­ized full face mask. If that does not work, then med­i­cal staff with turn to me­chan­i­cal ven­ti­la­tion, which re­quires the pa­tient to be se­dated heav­ily.

A tube is then in­serted through the tra­chea to carry oxy­gen di­rectly into the lungs as a ma­chine ef­fec­tively takes over the pa­tient’s breath­ing. In­tu­ba­tion is a ma­jor med­i­cal pro­ce­dure which can last for sev­eral weeks, re­quir­ing an en­tire med­i­cal team to mon­i­tor and ad­just as re­quired un­til the pa­tient can breathe on their own again un­aided. Some doc­tors have re­sorted to a new tech­nique: they ar­ti­fi­cially oxy­genate blood by ex­tract­ing it with a ma­chine and then re­turn­ing it into the body.

Newspapers in English

Newspapers from Kuwait

© PressReader. All rights reserved.