Christian Medical College (CMC) has opened an exclusive ward to manage severe cases of COVID-19 with a non-invasive respiratory support method. Under the 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 for NIV through the helmet interface. So far, 10 patients have been treated in this ward. Four of them improved and were shifted to the step-down ward. The others are still under treatment and improving, according to CMC Director J.V. Peter.
“We have already treated over 100 patients with the standard face mask interface in the regular intensive care units. There are clear protocols under which patients would be suitable for this type of NIV. The helmet interface is used for patients with a severe breathing difficulty,” he said.
In a press release on Monday, Dr. Peter said the lung was the primary organ that was affected by COVID-19. Some patients required oxygen supplementation, and when the lung was severely damaged, patients would require ventilator support. This was normally provided by the insertion of a tube in the windpipe, under sedation, and the patient is 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 that the patients did not require sedation and were able to speak and take intermittent feeds. “Although there were initial concerns over 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.