Attention to the Increasing Intubation Numbers in the Pandemic!

Intubation and mechanical ventilation (respiratory) support, which is an extremely important application in the treatment of patients during the COVID-19 pandemic, is actually used in many other diseases that cause respiratory failure. Pointing out that after the end of the epidemics, tracheal stenosis due to intubation and consequently shortness of breath may occur, Prof. Dr. Sina Ercan, Head of the Department of Thoracic Surgery, said that possible problems can be prevented to a large extent with the precautions to be taken.

The whole world is in a non-stop struggle with the Coronavirus COVID-19 pandemic. From the first days when the pandemic started to come to the forefront, new definitions that society is not very familiar with, except for healthcare professionals, have been pronounced frequently because it has become a pandemic over time and the effects it has created. One of them is the concept of "intubation".

Stating that this described intubation and mechanical ventilation process in intensive care units can be applied to many different diseases that cause respiratory failure in the lungs, Prof. Dr. Sina Ercan, Dean of Yeditepe University Faculty of Medicine and Head of the Department of Thoracic Surgery at Yeditepe University Hospitals, explained that the reason why it became frequently mentioned in this period was that the lungs were affected very frequently after the COVID-19 infection and that an increasing number of patients had to be intubated and connected to a ventilator. He pointed out that this is a situation where no country's health system is prepared for such a demand.

The Vast Majority of Patients with Respiratory Failure are Intubated

Reminding that the most characteristic effects of the coronavirus occur on the lungs and heart, Prof. Dr. Sina Ercan said, “As a result, sudden death can be seen in some patients in the middle of the street, and a more important consequence of this is that the condition of patients with respiratory failure may rapidly deteriorate and transfer to intensive care units may be required.”
Stating that a significant majority of these patients are intubated and connected to a ventilator, Prof. Dr. Sina Ercan said, “Since these patients cannot breathe strongly enough, a plastic tube called an intubation tube is placed in their trachea after they are put to sleep. The patient must be connected to a mechanical respirator in order to provide respiratory support to the highly edematous lungs. This support is continued until the lungs of the patients are cleared of infection.”

Undesirable After-Effects May Occur After the Pandemic

Prof. Dr. Sina Ercan, who said that all pandemics a similar process, although their size and results vary, reminded us that the Covid-19 pandemic will slow down and come to a standstill over time after a significant part of society develops immunity. However, pointing out that after-effects may occur after the pandemics is over, Prof. Dr. Sina Ercan said that after the Covid-19 pandemic, problems of tracheal stenosis due to intubation may be encountered. 
Stating that tracheal stenosis due to intubation is still a problem despite all technological and medical developments, Prof. Dr. Sina Ercan gave the following information on what may be encountered after the pandemic: “In today's Covid-19 pandemic, there is a group of patients who receive very intense intubation and mechanical ventilation treatment. A significant portion of these patients will be separated from their ventilators as a result of advanced medical support and treatments and will be discharged after recovery. On the other hand, our experience shows us that some of these patients who recover will have a high probability of developing lung damage and stenosis in the trachea due to intensive and high-pressure mechanical ventilation treatments.”

Potential Problems Can Be Prevented

Prof. Dr. Sina Ercan said, “The measures to be taken will help to minimize the possibility of patients who can survive the critical period after successful treatment, to be affected by tracheal (windpipe) stenosis and relevant problems in the coming days. Prof. Dr. Sina Ercan continued his words as follows: “During such a pandemic period, while trying to save the lives of the patients by hospitalization in the intensive care unit in the first place, attention should also be paid to simple precautions such as the opening of tracheostomies by experienced physicians in accordance with the technique, choosing cannulas suitable for the anatomical structures of the patients, not inflating the balloons of intubation tubes and tracheostomy cannulas with high pressure, not allowing the cannulas to which they are attached to be pulled excessively to one side due to the weight and tension of the ventilator sets. In this challenging period, we are discovering a new feature of Covid-19 infections, which we have only just begun to recognize, every day. While fighting this enemy, it is useful to keep in mind the health problems that have been known for a long time and can be largely prevented with simple precautions.”
 

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