As the number of seriously ill coronavirus patients in France climbs higher, intensive care medics say the lessons learned from early in the pandemic are leading to changes in how they treat the sick.
Doctor Alexandre Avenel has four COVID-19 patients in his intensive care ward in his hospital in north-eastern Paris.
All of them have depleted blood oxygenation levels but none are under intubation.
That might not have been the case six months ago.
As a second wave of the coronavirus sweeps across France, medics say the lessons learned from earlier in the year are leading to changes in how they treat coronavirus patients now.
“Little by little, we learned that if we can put off intubation, we probably should. When I look back, I tell myself that the first patients who came in, in March were generally in a much more serious condition than those we currently have in the last three weeks, in the last month. We talk about seriousness, but there are different levels of seriousness. The first patients who came were in catastrophic situations when they came, so I’m not sure we would have changed anything. But towards the end of April, we’ve tried to put off intubation and used all alternatives, and we realised that it worked”, Avenel says.
Avenel and his colleagues are delaying mechanical ventilation, a procedure which involves running a tube down a person’s windpipe.
Instead, they are increasingly placing non-sedated patients on their fronts and reducing the doses used in cortico-therapy.
Doctors have highlighted the risks of using invasive, mechanical ventilators too early or too frequently.
This refined approach reflects a broader shift on the frontlines of the pandemic in Europe and beyond, as doctors have rethought their use of mechanical ventilators to treat those suffering badly.