Christian Medical College (CMC) has set up an exclusive ward to manage patients with severe coronavirus disease (COVID-19) with a non-invasive respiratory support method. In this non-invasive ventilation (NIV), oxygen is delivered under high pressure to the patient by a ventilator using a snugly fitting face mask or a helmet interface.
The hospital has set up a 14-bed high dependency area exclusively for NIV using helmet interface. So far, 10 patients were treated in this ward of which four improved and were shifted to the step-down ward. The remaining six patients were on treatment and were improving, according to J.V. Peter, director of CMC.
“We have already treated over 100 patients with the standard facemask interface in the regular intensive care units. There are clear protocols in which patients would be suitable for this type of NIV. The helmet interface is used for patients with severe breathing difficulty,” he said.
In a press release issued on Monday, Dr. Peter said the lung was the primary organ that was affected in COVID-19. Some patients required oxygen supplementation and when the lung was severely damaged, patients would require ventilatory support. This was normally provided by the insertion of a tube in the windpipe, under sedation, and the patient would be connected to a ventilator.
“Evidence from various centres across the globe suggests that in these patients who go on to require invasive mechanical ventilation, the outcome may not be very good. There is now evidence that some of these patients can be managed by NIV. This is different from invasive ventilation in that oxygen is delivered under high pressure to the patient, by a ventilator, using a snugly fitting face mask or a helmet interface,” he said.
The advantage, he said, was the patients won’t require sedation and would be able to speak and take intermittent feeds. “Although there were initial concerns on the safety of healthcare workers in areas where this is provided, it is now evident that with the adequate use of personal protective equipment and increased frequency of air exchanges, there is no added risk to healthcare workers in these areas,” he added.
The ward was manned round-the-clock by therapists, nurses and doctors from the departments of Pulmonary and Respiratory Medicine. “We hope that the provision of such a facility will benefit patients and go a long way in improving the outcome of patients with severe COVID-19 infection,” he said.
