With no cure in sight, management of critically ill COVID-19 patients focuses on supportive care. Deltex says its haemodynamic monitoring system is an important tool in the critical care environment. The company is providing enhanced support to UK hospitals.
The media buzzword for treatments throughout the COVID-19 pandemic is undoubtedly “ventilators.” Here after all is a respiratory disease that affects the airways and as such compromises breathing. Acute Respiratory Distress Syndrome(ARDS) and Pneumonia are threats to life for COVID-19 patients. It’s logical, in a disease of the respiratory architecture, for clinical focus to be on delivery of oxygen.
Something else is happening though. Firstly it seems that COVID-19 patients are presenting with conditions not typical in ARDS. Lungs are described as being less “stiff” by practitioners. There are also reports of alveolar bleeding, so-called micro-thrombi in the lungs combining with ARDS to further impair oxygen absorption. Experts are even suggesting that compromised organ function in COVID-19 sufferers is as much about perfusion as it is about respiration. A recent paper in the journal Intensive Care Medicine puts it like this: “Increasing the delivery of oxygen to tissues involves, on the one hand, optimizing arterial oxygen content (hemoglobin concentration and saturation) and, on the other hand, optimizing flow to the tissues.”
“We are Getting this wrong”
This raises the subject of fluid balance, which has again been a recurring theme in COVID-19 ICU dialogue. Prof Dan Martin, of London’s Royal Free Hospital, Intensive Care Lead for High Consequence Infectious Diseases, summarises thus: “All centres agreed we are getting this (fluid balance) wrong,” which is at least part of the answer to the question of why we are seeing such high levels of Renal Failure.
So despite the intense focus on respiration, it’s also about achieving haemodynamic stability. UK monitoring specialist Deltex Medical says this is unsurprising given the weight of supportive clinical evidence. The problem, of course is that keeping patients breathing is already massively challenging, leaving little time for what can be (erroneously) seen as something of a therapeutic luxury.
Convincing the world that haemodynamic management is essential is Deltex Medical’s business. The company’s famous oesophageal Doppler monitoring system (ODM+) was originally conceived for intensive care and is well-suited to use in these very ill, often unstable patients. Why so? Because it measures central (aortic) blood flow, directly acquiring vital information by using a probe, inserted in the patient’s oesophagus. The resultant data quickly, accurately and simply delivers real-time haemodynamic data. Importantly in a fast-moving clinical setting it rapidly delivers the results of therapeutic measures, providing a useful guide to fluid and vasoactive drug interventions.
Deltex Medical CEO Andy Mears states; “What we absolutely know is that attaining haemodynamic stability is vital to achieve the balance between protecting the lungs and vital organs. This is why Deltex is offering heightened support to its UK customers in the form of free loan monitors and expertise.”
Source: Deltex Medical Ltd.