[1]: https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
by the way, the critically interesting thing in that piece from the lancet is that the rational for discouraging non invasive respiration is a lack of good masks and negative pressure rooms. These are problems where I think there has been an historical lack of imagination and are ripe for some novel solutions.
A few days after the surgery, he couldn't even breath on his own: MRI showed that parts of his brain were damaged. At that time, I think it's more sympathetic to let him go instead of making his life depending on a ventilating machine for the rest of his life.
The circumstances of this situation is that ventilated COVID patients often drown in their own plasma, get bacterial pneumonia or their lungs are irreparably destroyed. Like ECMO, this sort of ventilation is a hail mary procedure to try to salvage patients.
Even COVID survivors with mild symptoms, they may have reduced lung capacity due to lung damage.. and that may well be permanent. I suspect lung transplant lists will be backlogged the world over due to this pandemic.
We should be upfront about the odds of a full recovery and allow room for thoughtful discussion around patients’ wishes. The frenzied environment of ICUs during a pandemic isn’t conducive to this, so we need to be deliberate and talk about it as a country. The “job one is saving lives” rhetoric may not be best for patients and their families.
I’m not sure if that experience is caused by the ventilation, or by the disease and misattributed. In any case, I’ve decided not to get infected by this bug. And if I fail at that, I might even consider a living will excluding ventilation.
The first time they put some kind of special tube in under general. When I came to 3 days later there was no ventilator, and the end of the tube was in my throat. It felt like a rectangular block. They extubated me while I was awake and immediately put me on high flow oxygen. They would've intubated me on the spot if I couldn't breathe. Never felt a gagging sensation in this instance.