Managing the critically ill COVID-19 patient: From oxygen to ECMO
Published: 31 May 2020
The “COVID-19: Updates from Singapore” weekly webinar series is a forum for leading clinicians, scientists, public health officials and policy makers to share insights into their field of study. The eighth edition of the webinar was held on Thursday, 28 May 2020.
Associate Professor Graeme MacLaren, Senior Consultant at the Department of Cardiothoracic and Vascular Surgery and Director of Cardiothoracic Intensive Care at the National University Hospital (NUH), was this week’s invited guest. Speaking from experience as an adult and paediatric Intensive Care Physician, Assoc Prof MacLaren gave a broad overview of how medical devices can be used to keep COVID-19 patients alive until they recover.
TitledManaging the Critically Ill COVID-19 Patient: From Oxygen to ECMO, Assoc Prof MacLaren outlined the various available life support methods in the Intensive Care Unit (ICU), and how to administer critical care for the patient upon arrival, according to the usual standards of intensive care. The focus of his talk revolved around how the different types of life support were used for adult patients during the course of treatment in the unit, while he elaborated on how each method should be administered, under which circumstances. Besides, Assoc Prof MacLaren touched on how intensive treatment were administered to children who were diagnosed with COVID-19.
Overall, the dominant problems observed in COVID-19 patients are respiratory, substantial increase in haematological complications such as thrombosis that causes strokes in patients and kidney complications in ventilated patients, who then require short-term dialysis.
In addition, Assoc Prof MacLaren introduced and explained the hierarchy of life support from High-Flow Nasal Cannula (HFNC) and non-invasive ventilation to the use of the extracorporeal membrane oxygenation (ECMO) machine. He surmised that this hierarchy of life support were arranged as such, based on the recommendations of the National Institutes of Health in the United States. These methods of life support provided more effective oxygenation than conventional supplementary oxygen and it is much more comfortable for the patient. He cautioned that the invasiveness and the discomfort that the patient experience increases while going through the hierarchy of life support techniques, but they give physicians more control over the patient’s physiology.
Click here to watch the full session of the webinar.
Join us in the next “COVID-19: Updates from Singapore” session on 4 June 2020, featuring guest speaker Assoc Prof Audrey Chia, Director, Leadership Development Programme, NUS Business School and Joint Associate Professor, NUS Medicine. Register now at https://medicine.nus.edu.sg/cet/webinar/.
