24-Hour Crisis Hotline: (877)SAFEGBC or (877)723-3422 Mental Health & Substance Abuse Issues

6502 Nursery Drive, Suite 100
Victoria, TX 77904
Fax: (361)578-5500
Regular Business Hours: Monday - Friday 8am - 5pm
Every 3rd Thursday of the Month - Extended Hours Until 7 pm

Medical Disorders
Basic InformationLookupsLatest News
Half of Americans Still Not Wearing Masks When Out in Public: PollFor Maximum Effectiveness, De-Stress and Get Healthy Before Your COVID ShotUK Prime Minister Says British COVID Variant May Be More DeadlyImmune System May 'Remember' Infections From Previous CoronavirusesYou're More Likely to Maintain Social Distance If Your Friends Do: StudyExercise Doesn't Boost Health If You Stay Obese, Study FindsEven When Cancer Is in Remission, Patients' Risks of Severe COVID RiseFor Rising Number of People, Obesity Is a Literal HeadacheSevere Allergic Reaction Extremely Rare With Pfizer COVID Vaccine: StudyWill Vaccines Work Against the New Coronavirus Variants?More Than 200,000 Americans Have LupusKids Highly Likely to Transmit Coronavirus to Others: StudyArthritis Drug Tocilizumab Flops as COVID-19 TreatmentBiden Unveils Details of National Pandemic Response PlanDental Practices Rebound as U.S. Dentists Look Forward to COVID VaccineAHA News: COVID-19 Registries Offer Lessons Beyond the CoronavirusCOVID-19 Ups Complication Risks During ChildbirthWhen ICUs Near Capacity, COVID Patients' Risk for Death Nearly DoublesGetting the COVID Vaccine? A Good Night's Sleep Will HelpAmerica Sees COVID Deaths Top 400,000, While New Variants Worry ScientistsNasal Spray COVID Vaccine Shows Promise in Animal TrialsFried Food a Big Factor in Heart Disease, StrokePromising Steps Toward Retinal Cell Transplants to Fight BlindnessDo You Socially Distance? Your Income Might MatterIf a Nursing Home Resident Gets a COVID Shot, Can Their Families Visit Them Now?Vision Problems? Here's a Guide to Which Specialist Is Right for YouShould Your Child Get a COVID Test?New Hope Against Diseases Marked by Progressive Scarring of Lung TissueAHA News: What Heart and Stroke Patients Should Know About COVID-19 VaccinesCOVID Pandemic Shortened U.S. Life Expectancy by More Than a YearShorter COVID Quarantine for College Athletes a Good Idea, Study FindsWhat Happened to the Flu This Year?3 Steps Could Nearly Eliminate COVID Infections on College Campuses: StudyPharmacy Chains Ready to Supply COVID-19 Vaccines to AmericansI've Already Had COVID-19, Do I Need the Vaccine?What Will COVID-19 Look Like Years From Now?First Computer Model of Entire COVID Virus Will Aid ResearchStopping Common Heart Meds Could Be Risky for Kidney PatientsU.S. COVID Vaccine Rollout Nears 1 Million Doses Per DayJohnson & Johnson's One-Dose COVID Vaccine Promising in Early TrialLockdowns' Benefits for Air Quality Weren't as Big as Thought: StudyPeople's 'Microbiomes' Might Influence COVID-19 Severity: StudyNew Insights Into How COVID-19 Damages the BrainCollege Campuses Are COVID 'Superspreaders,' Study FindsStuck at Home, Suffering With COVID? Experts Offer Guidance on CareCOVID Daily Death Toll Sets New U.S. Record, Soars Past 4,400AHA News: Registries Could Offer Insight Into COVID-19's Impact on College Athletes' HeartsResearch Reveals Why COVID Pneumonia Is More DeadlyPandemic Is Tied to Big Rise in U.S. Heart DeathsCommon Diabetes Meds Tied to Serious COVID-19 Complication
Questions and AnswersLinks
Related Topics


Ventilators May Leave COVID Survivors With Windpipe Injuries

HealthDay News
by By Amy Norton HealthDay Reporter
Updated: Nov 30th 2020

new article illustration

MONDAY, Nov. 30, 2020 (HealthDay News) -- COVID-19 patients who end up on a ventilator may be at risk of rare but serious injuries to the throat, a new study suggests.

The study, at one hospital in Italy, found a high rate of the injuries among COVID-19 patients treated early on in the pandemic. Of 30 who spent at least two weeks on a ventilator, nearly half sustained injuries to the trachea (windpipe) that are normally rare.

Experts said it's not clear how common the injuries might have been at other hospitals earlier in the pandemic. And the risks may be different now, as doctors have learned more about treating COVID-19.

"The management of COVID-19 patients in the second wave is quite different from the first wave," said Dr. Giacomo Fiacchini, the lead author on the study.

At his hospital -- Azienda Ospedaliero-Universitaria Pisana, in Pisa -- fewer patients end up on ventilators now.

"There is no longer the rush to mechanically ventilate these patients," Fiacchini said. "So the number of intubated patients who need many days of invasive mechanical ventilation has been reduced."

Mechanical ventilators supply potentially life-saving air to patients who cannot breathe on their own, via a tube threaded down the trachea.

But that tube can sometimes place too much pressure on the tracheal tissue, leading to large lesions or even fistulas -- abnormal tissue connections between the trachea and the esophagus (the tube that takes water and food from the mouth to the stomach).

Normally, that's a rare risk.

The pandemic, however, has not been a normal time. Of the 30 COVID-19 patients Fiacchini's team studied, 47% suffered a tracheal injury.

All were on ventilators for two weeks or more. But that alone did not explain the high injury rate: The researchers compared their COVID-19 patients with a control group of 45 patients who'd been on ventilators for a similarly long time the year before -- when no one had COVID-19.

And only 2% of those patients suffered a tracheal injury, the findings showed.

U.S. critical-care specialists said they were not aware of any hospitals in the United States reporting similar patterns.

"This is a pretty small study," said Dr. Gabriel Lockhart, who directs the intensive care unit at Saint Joseph Hospital/National Jewish Health in Denver.

"This gives us a signal," Lockhart said. "There could be some fire behind the smoke, but it's hard to know if this is seen more broadly."

Dr. Greg Martin, president-elect of the Society of Critical Care Medicine, agreed.

He noted that the patients, all hospitalized between March and May 2020, fell ill earlier in the pandemic, in a country that was one of the earliest hit.

There has been a "learning curve" in managing COVID-19 patients, Martin said. And during the initial surge, staff and resources at some hospitals were stretched thin. It's not clear how much of a factor that was in the United States, he added.

The Italian doctors speculate on some potential reasons for the tracheal injuries. For one, all of their COVID-19 patients were given anti-inflammatory corticosteroid drugs, at high doses.

Lockhart agreed that could have been a factor. The drugs suppress the immune system, which might impede healing of any tissue breakdown caused by the ventilator tube.

It's also possible that placing ventilator patients in the prone position (on the stomach) contributed, according to Fiacchini.

During the pandemic, doctors have found that hospitalized COVID-19 patients can get more oxygen if they spend time in the prone position.

But maneuvering ventilator patients into position might contribute to tracheal injuries, the Italian team speculated.

No one suggested the prone position be abandoned, since it appears generally beneficial.

Instead, Martin said, the risk of tracheal injuries can be mitigated by, for example, closely monitoring the pressure in the ventilator tube and adjusting it so it's not continuously resting in the same place.

The findings highlight a broader point, Martin and Lockhart said: Patients who survive a serious COVID-19 infection can face complications and a long recovery.

The experience of a long intensive care unit (ICU) stay, alone, can cause so-called "post-ICU syndrome," Martin noted. Those problems range from lost muscle mass and strength, to issues with memory and thinking, to post-traumatic stress.

"Even for those who recover [from COVID-19]," Lockhart said, "it's often not a smooth road. Your life may not be the same afterward."

The findings were published online Nov. 19 in JAMA Otolaryngology Head & Neck Surgery.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19's long-term effects.

SOURCES: Giacomo Fiacchini, MD, otolaryngology, audiology and phoniatric operative unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy; Gabriel C. Lockhart, MD, director, intensive care unit, Saint Joseph Hospital, assistant professor, medicine, National Jewish Health, Denver; Greg S. Martin, MD, MSc, president-elect, Society of Critical Care Medicine, Mount Prospect, Ill., and professor, medicine, Emory University School of Medicine, Atlanta; JAMA Otolaryngology Head & Neck Surgery, Nov. 19, 2020, online