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tigerskin
LSU Fan
Member since Nov 2004
29479 posts

New study out about intubation and extubation for Covid
This group actually had over 50 percent get off the vent.

“Conclusion
In addition to clinical signs of respiratory distress, patients with COVID-19 who are older, male, or diabetic are at higher risk of requiring intubation. Among intubated patients, older and more obese patients are at higher risk for prolonged intubation. “

LINK
This post was edited on 5/23 at 10:23 am


CoachChappy
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Boudin Capitol of the World
Member since May 2013
25334 posts
 Online 

re: New study out about intubation and extubation for Covid
quote:

older and more obese patients are at higher risk for prolonged intubation. “


Not many talking heads mention this enough. My sister works on the covid floor at a hospital in La. 100% of patients are obese, diabetic, heart disease, or a combo of the 3. A very large % are AA.
This post was edited on 5/23 at 10:28 am


LSUJML
LSU Fan
BR
Member since May 2008
20582 posts
 Online 

re: New study out about intubation and extubation for Covid
quote:

Among intubated patients, older and more obese patients are at higher risk for prolonged intubation


I know a guy through work, he’s in NY
Would guess late 50’s early 60’s & obese
Spent 6 weeks on a vent & is home now


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lsunurse
LSU Fan
Scottsdale, AZ
Member since Dec 2005
122441 posts

re: New study out about intubation and extubation for Covid
quote:

My sister works on the covid floor at a hospital in La. 100% of patients are obese, diabetic, heart disease, or a combo of the 3. A very large % are AA.



We still saw some at my hospital that were late 30s to early 40s that ended up on vents for a prolonged time. Not overweight at all. Non smokers. Not a druggie, not an alcoholic. No diabetes, no heart disease. No previous medical history at all. One I'm thinking of specifically stayed on the vent for over a month and nearly died several times before eventually recovering.






Hangover Haven
LSU Fan
Metry
Member since Oct 2013
14453 posts

re: New study out about intubation and extubation for Covid
quote:

Conclusion
In addition to clinical signs of respiratory distress, patients with COVID-19 who are older, male, or diabetic are at higher risk of requiring intubation. Among intubated patients, older and more obese patients are at higher risk for prolonged intubation. Otolaryngologists consulted for airway management should consider these factors in their decision making.


Thanks Captain....

quote:

Otolaryngologists


AKA ENT...Who the frick even uses this term...

Sage Journals, I guess...

quote:

Otolaryngologists consulted for airway management should consider these factors in their decision making.


and what's their decision making? Weather to trach them or not...? Generally, if someone is intubated for longer than two weeks, the pulmonologist will consult for a trach.
Other than doing trachs, ENTs didn't play much of a factor in Covid treatment...

Weird article...
This post was edited on 5/23 at 10:51 am


tide06
Alabama Fan
Raleigh, NC
Member since Oct 2011
3430 posts
 Online 

re: New study out about intubation and extubation for Covid
quote:

We still saw some at my hospital that were late 30s to early 40s that ended up on vents for a prolonged time. Not overweight at all. Non smokers. Not a druggie, not an alcoholic. No diabetes, no heart disease. No previous medical history at all. One I'm thinking of specifically stayed on the vent for over a month and nearly died several times before eventually recovering.


So no pulmonary history?

Was hearing info suggesting that any compromising of the lung tissue meant big problems if infected and that even post release they were having serious reductions in lung function.


lsunurse
LSU Fan
Scottsdale, AZ
Member since Dec 2005
122441 posts

re: New study out about intubation and extubation for Covid
quote:

So no pulmonary history?


The one specific case I'm talking about...none at all.


I had to go through that patient's chart in depth to report all this information to public health. The patient was one of our first cases so public health wanted all kinds of information on the patient.


I do think most of the ones really struggling fit the risk factors listed. It is just the randomness of how it has hit completely healthy, relatively young people so hard that has been concerning. Not saying that is the norm at all...cause it hasn't been.


tigerskin
LSU Fan
Member since Nov 2004
29479 posts

re: New study out about intubation and extubation for Covid
quote:

We still saw some at my hospital that were late 30s to early 40s that ended up on vents for a prolonged time. Not overweight at all. Non smokers. Not a druggie, not an alcoholic. No diabetes, no heart disease. No previous medical history at all. One I'm thinking of specifically stayed on the vent for over a month and nearly died several times before eventually recovering.




Over a period of a normal few months, how does that compare to young healthy patients coming in for car accidents?


Hangover Haven
LSU Fan
Metry
Member since Oct 2013
14453 posts

re: New study out about intubation and extubation for Covid
quote:

We still saw some at my hospital that were late 30s to early 40s that ended up on vents for a prolonged time. Not overweight at all. Non smokers. Not a druggie, not an alcoholic. No diabetes, no heart disease. No previous medical history at all. One I'm thinking of specifically stayed on the vent for over a month and nearly died several times before eventually recovering.


Sounds familiar...

37y/o This was one of ours... We were proning her for up to 21 hours a day.. Amazing to see this day...

FOX 8
This post was edited on 5/23 at 11:00 am


lsunurse
LSU Fan
Scottsdale, AZ
Member since Dec 2005
122441 posts

re: New study out about intubation and extubation for Covid
quote:

Over a period of a normal few months, how does that compare to young healthy patients coming in for car accidents?





Apples to oranges. Car accidents happen all the time. We all know that is a risk and know people of all ages that have been killed in them.


I'm just saying....going through that one patient's chart and realizing the patient had no obvious previous health history (and they didn't uncover some underlying health issue that had been there all along) and seeing just how close to death that patient was at....not gonna lie...it spooked me a little(as it spooked many of the staff caring for that patient). That was the moment I took things a little more seriously. Then with more reports of young people with COVID having strokes, etc. Just added to me not completely dismissing this as something only the old and unhealthy need to worry about.


But I remain in the cautious middle of all this. I'm not on the extreme "keep everything shut down until there is a vaccine" group. But I'm also not in the "open everything up as it was before this because there is NOTHING to worry about" group either. I'm in the "open things up but let's remember this thing is still out there and use caution and good judgement" group.


And no...I have not made a TikTok video. I do not have a sign in my yard proclaiming I'm a healthcare hero. And I don't have fb posts about that either.





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Cosmo
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Member since Oct 2003
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re: New study out about intubation and extubation for Covid
Its disgusting to me that all nursing home patients dont have DNR/DNI orders

If you are so debilitated that you have to be dumped in a nursing home it is cruel and unusual punishment to shove a tube down your throat to keep you alive. And even if you live you will be even more debilitated and quality of life will be even worse than before.


Hangover Haven
LSU Fan
Metry
Member since Oct 2013
14453 posts

re: New study out about intubation and extubation for Covid
quote:

Its disgusting to me that all nursing home patients dont have DNR/DNI orders


Or do not transfer orders for that matter...

I completely agree with this statement...


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tigerskin
LSU Fan
Member since Nov 2004
29479 posts

re: New study out about intubation and extubation for Covid
I am basically in the same group.

I am also in the healthcare field. Unfortunately though I am starting to see patients with other conditions that now have a worse prognosis than if they would have been seen a few months ago.

This post was edited on 5/23 at 11:13 am


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CoachChappy
LSU Fan
Boudin Capitol of the World
Member since May 2013
25334 posts
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re: New study out about intubation and extubation for Covid
quote:

Non smokers. Not a druggie, not an alcoholic. No diabetes, no heart disease. No previous medical history at all.

Is that what he told you? Did he get an echo to check his heart? Hell, I never tell the doctor that I smoke cigars and drink. I don’t want them tipping off my insurance.


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touchdownjeebus
New Orleans Pelicans Fan
Member since Sep 2010
14140 posts

re: New study out about intubation and extubation for Covid
I read somewhere that 50% of all deaths are obese. The study suggested that lipids allow the virus to move more freely through the body. I don’t know if I buy that or not, but it was interesting. We still don’t know very much about this thing, hence the goal posts moving almost daily.
This post was edited on 5/23 at 11:21 am


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lsunurse
LSU Fan
Scottsdale, AZ
Member since Dec 2005
122441 posts

re: New study out about intubation and extubation for Covid
That's awesome.

The day that patient I talked about was finally discharged many staff lined up to see the patient off and clap as they wheeled the patient out.


It was a moment so many of us at work needed. To see this patient...that many thought would surely die and almost did several times...go home. It lifted so many spirits that day.


Hangover Haven
LSU Fan
Metry
Member since Oct 2013
14453 posts

re: New study out about intubation and extubation for Covid
quote:

It was a moment so many of us at work needed. To see this patient...that many thought would surely die and almost did several times...go home. It lifted so many spirits that day.


It was amazing to see her discharged..

She was basically the same way..Along with the vent for six weeks, she was on CRRT, and many pressers... We actually have quite a few patients like her that were D/C'd.. They did the story on her because of the baby...
This post was edited on 5/23 at 11:43 am


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tiger91
LSU Fan
South of Lafayette
Member since Nov 2005
24076 posts

re: New study out about intubation and extubation for Covid
quote:

Its disgusting to me that all nursing home patients dont have DNR/DNI orders


Well that's not quite fair .. where I do consulting, we have some who admitted themselves as they didn't want to live alone anymore OR they didn't want to be in their families way in their home OR a few other reasons.

Not all are dumped. There are plenty of residents who enjoy socializing with each other, playing cards, watching movies, going on outings -- they really have no reason to be a DNR. Some really NEED to be DNR but not by any means all.


klrstix
LSU Fan
Shreveport, LA
Member since Oct 2006
2018 posts

re: New study out about intubation and extubation for Covid
quote:

It was a moment so many of us at work needed. To see this patient...that many thought would surely die and almost did several times...go home. It lifted so many spirits that day.


I am glad to hear of this patients recovery both for their sake and for you and your coworkers...

As a person used to work at a hospital in the patient care side for almost a decade, I can recall 3 specific instances when patients came into our department (I worked in Radiology...) and within 10 minutes of their arrival they coded for no discernible reason. Of those 3 two passed and 1 ended up in a coma. No one was ever able to figure out why they coded. I know how incredibly unsettling these experiences were for everyone in our department.

This post was edited on 5/23 at 11:50 am


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MiloDanglers
Ole Miss Fan
on a dock on a bay
Member since Apr 2012
6041 posts

re: New study out about intubation and extubation for Covid
quote:

I'm just saying....going through that one patient's chart and realizing the patient had no obvious previous health history (and they didn't uncover some underlying health issue that had been there all along)


Maybe a Vitamin D issue ? Do you check for that


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