Man 'facing death' battles back from COVID-19 with help of bold new therapy

[modrepub]

David Lopes, of Gettysburg, was believed to be the first confirmed COVID-19 patient at Wellspan York Hospital when he showed up with severe symptoms March 18.

He required a ventilator almost immediately, which wasn’t a good sign. Statistics show 80 percent of virus patients who go on the ventilator don’t survive.

Nine days into his hospitalization, Lopes, 56, ripped out his ventilator while sedated, putting his recovery in even more jeopardy. His doctors re-intubated him but believed he was facing imminent death.

That’s when doctors decided to try a rare treatment approved just this month in the United States for use on COVID-19 patients: an ECMO machine. Extracorporeal membrane oxygenation has been around since the 1970s, but it has only been used about 540 times across the world during this pandemic. It is considered “a last-ditch effort” to save a patient’s life by acting as an artificial lung,

Tubes from the machine were attached to ports on Lopes’ jugular and femoral arteries to add oxygen to his blood and remove carbon dioxide. The device would give his terribly inflamed lungs a chance to rest.

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One thing doctors have learned about using ECMO with COVID-19 patients, is to not wait too long.

Doctors in Bejing used ECMO about five times, but didn’t have good results, Zubkus said, so it was initially thought that the treatment wouldn’t be helpful for the virus.

But doctors in France used it about 150 times, and started using it earlier in a patient’s decline. So instead of monitoring a patient’s downward trajectory, and trying different therapies such as temporarily paralyzing patients and then turning them on their bellies, which are steps that can improve oxygen flow, doctors shifted more quickly to ECMO on patients.

“France taught us that earlier is better. So we pull the trigger earlier,” Zubkus said. “If things don’t work for a patient, we don’t need to wait 24 hours to see what’s going to happen because we know where this is going to go.”


link: https://www.pennlive.com/news/2020/04/man-facing-death-battles-back-from-covid-19-with-help-of-bold-new-therapy-at-york-hospital.html

[hlthe2b]

1. ECMO is NOT new. Used for other forms of ARDS and similar, including that caused

by Hantavirus (HPS), other infectious agents and even ARDS secondary to the most severe forms of pancreatitis.

Not widely used for COVID-19 as of yet because it is EXTREMELY labor, staff and equipment/resource-intensive and can potentially spread virus like few other procedures to attendant HCWs. Not to mention the need for anti-coagulation to use it and the fact that considerable COVID-19 patients have coagulopathies to begin with.