U of C doctors find effective ventilator alternative for coronavirus patients

Doctors at University of Chicago Medicine’s Hyde Park emergency room have found a seemingly effective alternative to mechanical ventilators when treating struggling coronavirus patients.

High-flow nasal cannulas — small prongs that blow heated, humidified oxygen into a patient’s nostrils — provide respiratory aid just like ventilators, but are much less invasive.

And Michael O’Connor, UChicago Medicine’s Director of Critical Care Medicine, said in a Thursday press release that the use of cannulas during this COVID-19 pandemic has led to “truly remarkable” success.

As of Thursday, 24 emergency room patients — all in “respiratory distress” — had been given cannulas, and most “fared extremely well.” The cannulas, in general, increased each patient’s oxygen level from 40% to as high as 90%.

Most impressively, only one of the 24 patients eventually required intubation with a ventilator after 10 days with the cannulas.

That 1-in-24 number compares drastically with another statistic: only 50% of UChicago Medicine COVID-19 patients intubated with ventilators during the pandemic have improved enough to have the ventilator tube removed.

There are other benefits to using cannulas instead of ventilators, too.

Mechanical ventilation has been the most common treatment worldwide for hospitalized coronavirus patients, leading to a global shortage of ventilators. About 55% of the ventilators in Illinois were in use as of Friday, with almost a quarter of them being used to treat COVID-19 patients, according to the Illinois Dept. of Public Health.

Cannulas, meanwhile, are in lower demand.

And intubation, which involves inserting a breathing tube into the windpipe, is relatively invasive and can cause side effects like lung injuries.

“Avoiding intubation is key,” said Thomas Spiegel, Medical Director of UChicago Medicine’s Emergency Department. “Most of our colleagues around the city are not doing this, but I sure wish other ERs would take a look at this technique closely.”

Between 50% and 80% of Illinois coronavirus patients who were placed on ventilators have died, according to state Public Health Director Dr. Ngozi Ezike. During a Thursday news conference, she commended specialists “trying different, more innovative ways to try to increase the oxygenation in patients.

“We are seeing that here, and appreciating all these pulmonary intensivists who are trying to find new ways to care for this very serious disease,” Ezike said.

As of Thursday, UChicago Medicine’s coronavirus pandemic totals included 297 successful discharges and 137 active patients, with 27 on ventilators.

Statewide, 4,699 people were hospitalized with the virus as of Friday, with 763 on ventilators, Illinois health officials said.

Contributing: Tina Sfondeles