Would you go on a ventilator?

4,563 Views | 22 Replies | Last: 5 yr ago by Rongagin71
jebeka
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Last year my mom pass away due to complications from a cold. She had COPD which forced her to decide whether to go on a ventilator. She had documents in her will/health requests to prevent this action. Of course, when you can't breath you make decisions differently. She was in good health outside of COPD.

Going on a ventilator is a huge decision with potentially grave consequences. She couldn't be weened from the unit for well over a week and was kept unconscious for the most part during the time. Doctors eventually came to us saying they needed to get her off it in the next 24 hours or she would need a tracheotomy for a permanent ventilator and be moved to a center that manages these kind of patients.

We were beside ourselves knowing she did't want to wake up in that condition with essentially no chance of recovery. Fortunately, the next morning she was successfully weened off the ventilator. She couldn't swallow due to the extended period on the ventilator and was being fed via feeding tube. Then the next decision, do we surgically insert a feeding tube? Again, she finally passed a swallow test. Finally, being oxygen deprived and on a ventilator so long her mental abilities had been compromised. She was unable to get out of bed.

The hospital wanted to release her but we couldn't care for her and it was extremely difficult to find a place that would take her in this condition but we did locate a place in the Woodlands. Her condition deteriorated and she eventually passed away after 6 weeks of battling.

Hospitals are very capable of keeping people alive using a ventilator. The issue is the quality of life.

Imagine if a person in their 50s comes down with Covid and needs a ventilator to survive? For me, I'd decline it. I couldn't imagine waking up in 2-3 weeks on a trach ventilator, with some mental impact. Then living for 20-30 years in a limited mental state. I couldn't put my family through that.

Cuomo mentioned people needing a ventilator for 3-4 weeks with Covid. That means a trach ventilator which is very life changing. I think I'd pass and call it a good life.
Snow Monkey Ambassador
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AG
You understand that people get better, right? This isn't an issue of a persistive vegitative state, it's living long enough to defeat the virus.

Good lord.
Crocs
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While what you described is terrible in and of itself, these are two very different things
MTVs Celebrity Deathmatch
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Yes, I would go on a ventilator. I believe intubation success rates are around 45%. Many people are in "good" health, they just can't breath for a large variety of reasons
AgGrad99
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Snow Monkey,

While I agree with your sentiment...maybe soften the delivery a tad? The guy lost his mom.
Complete Idiot
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There are many people afraid of this situation, some perhaps irrationally but fear is fear, and I don't think you posting your opinion about this is helping them.

I would suggest everyone listen to a medical doctor if they or a loved one are presented with an option for a ventilator. Which is unlikely for most, regardless of Covid 19.
TRADUCTOR
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Cowboy up and take the ventilator, don't put your family through arguing with you. Use that doctor thread to get square on COVID, no, just cowboy up.

Infection_Ag11
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AG
Would I? Yes, but I'm a healthy male in my 30s and most of the reasons why I would be put on a ventilator would be reversible with a reasonable prospect of recovery.

The average intubated COVID patient (60s-80s with multiple underlying conditions) is far less likely to survive however.

Of all the patients I intubated in residency, I'd say around 40% should have been DNR and had no prospect of meaningful recovery. Unfortunately in this country we don't like to have those conversations until it's too late.
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MasterAggie
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Quote:

While what you described is terrible in and of itself, these are two very different things
What he is saying is that for some it is very difficult to get off a ventilator. Not that every coved patient will wind up in his moms situation. Sometimes the body will not adjust back and you're unable to come off successfully. My dad didn't want to go on one because of that risk. Thankfully he came off with ease.
SanDiegoAg12
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My dad came down with metapneumo virus and strep at the same time last year. This was on a ski trip where they were at 8,000 feet. His condition quickly deteriorated until he was hospitalized and immediately put in the ICU with double pneumonia. After trying a nasal canula and oxygen mask they determined he had to be moved to a ventilator to have a chance at beating it. He was in good health at the time and we didn't think twice. They put him under for 8 days until he passed a breathing test and they were able to remove the vent.

Definitely lots of complications immediately following the use of such strong narcotics and sedatives during those 8 days but in the end it saved his life.

Short answer - yes
CowboyGirl
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My dad died of aspiration pneumonia. He already had a DNR and also was able to shake his head "no" when my mom asked if he wanted to go on a ventilator if he needed it. We were so relieved we didn't have to make those choices without his input.
kyledr04
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I would because if I needed it I think it would be my best chance to survive. I have a young family. But the thought of them needing to withdraw support if needed is terrible. Another reason for having these discussions and documention.

I think most people (even elderly or patients with some other comorbidities) would benefit if covid was their primary reason for intubation. Its different than other scenarios where recovery or quality of life is questionable. But I'd definitely understand people that wanted DNR and family would need to weigh all the other factors.
Dad
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My dad needed a ventilator five years ago in order to save his life and he had said previously he didn't want life support but he meant that he didn't want to be a vegetable with machines keeping him alive.

I told my mom that if the doctor thought he had a good chance of recovery then we needed to give it a shot until the doctor told us he didn't anymore.

My dad fully recovered to the level of health he was at before that incident and is still alive today.

I'm in my 30s. If I get covid and end up in that situation I probably have a pretty decent chance to recover if they can keep me alive so my answer is definitely yes to a ventilator.
bay fan
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S
Sorry about your mom. However, I don't think you can compare the outcome of a compromised, older individual to what you might expect yourself.

I am 55, healthy, strong and physically active and have a DNR for catastrophic things in place. I absolutely would want a ventilator should I be stricken with this virus as I believe my chances of recovery are as good as anyone in my age bracket.
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puryearag85
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Damn skippy I would!
Dr. Not Yet Dr. Ag
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Infection_Ag11 said:

Would I? Yes, but I'm a healthy male in my 30s and most of the reasons why I would be put on a ventilator would be reversible with a reasonable prospect of recovery.

The average intubated COVID patient (60s-80s with multiple underlying conditions) is far less likely to survive however.

Of all the patients I intubated in residency, I'd say around 40% should have been DNR and had no prospect of meaningful recovery. Unfortunately in this country we don't like to have those conversations until it's too late.
Had a woman who got taken off hospice so she could be treated for COVID-19 the other day, already on 6L NC at her clinical baseline. Family wanted her to be full code. That whole situation gave me a gigantic headache.
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Aries
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WTF?? People are so crazy.
jgo
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S
Long story short, many years back my dad went on a vent. He was 65 at the time, they could not get him weaned off and wanted to trache him. I was Med POA, he had told me in the past that he never wanted to be on a vent and never wanted a trache. I was prepared to honor those wishes, when I got a call in the middle of the night saying that my dad had extubated himself and they would need to do a tracheotomy to save him. I denied the request, a young Dr got on the phone with me and pleaded that I let him do it because he thought my dad had some good years left. My dad was not a healthy person, but I relented and gave the Dr approval to do the procedure. Thanks to that Dr, I got probably my best 10 years out of my dad. Our relationship was better than any time in my life up until his death in Sept of 2017, 10 years later.

My brother went on a vent sometime in Aug of 2016, he made the decision to come off of it in Jan of 2017. He died shortly thereafter. I've seen both sides of living on a vent. It is not an easy decision, but I can say do your family a favor and make sure they know your wishes. Also make sure you know, are informed and educated before you make any blanket statement that could be a very permanent solution to what may be a temporary problem.

Infection_Ag11
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Aries said:

WTF?? People are so crazy.


Unfortunately it's not uncommon. Patients (and moreso families) always think they're ready for death until it's kicking down the door.
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Marcus Aurelius
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https://www.nejm.org/doi/full/10.1056/NEJMoa2004500?query=featured_home

Seattle experience of 24 COVID-19 ICU pts. 50% mortality. 18 of 24 required mechanical ventilation. 6 of these were extubated and discharged. Mean ventilator duration of these 6 was 10 days. This echos my experience.
Infection_Ag11
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Marcus Aurelius said:

https://www.nejm.org/doi/full/10.1056/NEJMoa2004500?query=featured_home

Seattle experience of 24 COVID-19 ICU pts. 50% mortality. 18 of 24 required mechanical ventilation. 6 of these were extubated and discharged. Mean ventilator duration of these 6 was 10 days. This echos my experience.


50% is damn good it seems, some centers reporting 70-80%.
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Marcus Aurelius
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Yeah. As we get more and more. Day 7-9 increased hypoxia to ICU is an ominous sign. I have a severe ARDS pt proned with virtually no lymphocytes. This N/L >>>> 20. Don't think he'll make it.
Rongagin71
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I was in an oxygen tent as a baby but recovered and have lead a healthy life.
Would have to shave to put on a mask now, but may have to...
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