ICU deaths fall at St. Paul’s

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ICU DEATHS FALL AT ST. PAUL’S AS KNOWLEDGE ABOUT CORONAVIRUS LEADS TO NEW TREATMENTS

October 30, 2020

[Excerpts] While the number of patients in St. Paul’s Hospital’s intensive care unit has roughly doubled since the early days of the COVID-19 pandemic last spring, the death rate among these acutely ill people has decreased since then, says a St. Paul’s ICU doctor.

That’s because a deeper understanding of how COVID-19 affects the body has changed and improved the course of treatment for seriously ill ICU patients, says Dr. Del Dorscheid, also a principal investigator at the Centre for Heart Lung Innovation.

Inflammation a big problem in acutely ill COVID patients

Another change in the ICU is the advancement of targeted treatments – a result of ongoing research from around the world. At the outset, doctors thought COVID was a severe respiratory illness. “Initially it was called a viral pneumonia with acute respiratory distress syndrome (ARDS), and that’s what we treated ICU patients for,” says Dr. Dorscheid. “But now, we’ve learned critically ill infected patients aren’t really suffering from ARDS, and that many features or ARDS are not present.”

He says experts have learned that the biggest challenge facing seriously ill COVID patients is a severe inflammatory response to the infection that can cause small clots, or emboli, to form throughout the body. They can lead to deadly complications like multi-organ failure and strokes.

While the number of patients in St. Paul’s Hospital’s intensive care unit has roughly doubled since the early days of the COVID-19 pandemic last spring, the death rate among these acutely ill people has decreased since then, says a St. Paul’s ICU doctor.

That’s because a deeper understanding of how COVID-19 affects the body has changed and improved the course of treatment for seriously ill ICU patients, says Dr. Del Dorscheid, also a principal investigator at the Centre for Heart Lung Innovation.

Inflammation a big problem in acutely ill COVID patients

Another change in the ICU is the advancement of targeted treatments – a result of ongoing research from around the world. At the outset, doctors thought COVID was a severe respiratory illness. “Initially it was called a viral pneumonia with acute respiratory distress syndrome (ARDS), and that’s what we treated ICU patients for,” says Dr. Dorscheid. “But now, we’ve learned critically ill infected patients aren’t really suffering from ARDS, and that many features or ARDS are not present.”

He says experts have learned that the biggest challenge facing seriously ill COVID patients is a severe inflammatory response to the infection that can cause small clots, or emboli, to form throughout the body. They can lead to deadly complications like multi-organ failure and strokes.

Oxygen, not ventilators
Dr. Dorscheid says many ICU patients are hypoxic (meaning their tissues are starved of oxygen), and for them, being placed on a ventilator, a treatment of last resort that can lead to serious, lasting harm, is not appropriate for those with COVID pneumonia.

“Part of what we’ve learned is hypoxic patients need oxygen, not ventilators.” The ventilator does not fix all causes of hypoxia.
To read the full article, click on: ICU DEATHS FALL AT ST. PAUL’S AS KNOWLEDGE ABOUT CORONAVIRUS LEADS TO NEW TREATMENTS