David, that is really whom I am working with. We have no vented patients in my area. Sadly, we are doing very little. There is no treatment for the virus itself, so we essentially are treating symptoms and providing comfort.
Breathing difficulty is the hospitalization threshold. As long as the lungs are effectively exchanging O2, you stay home. Once hospitalized, O2 therapy is used. We measure the amount of O2 being carried around the blood, usually via a finger probe, measuring O2 saturation levels. We strive to keep this number above 90%. If it drops below this, we turn up the oxygen. Once we hit 6-8 Liters of O2, we begin high flow O2 treatments. 8-15 L of O2, humidified and heated. This is pretty effective, but obviously the patient cannot continue to survive with this kind of intervention.
Other than that, we are giving high doses of Vitamin C, Vitamin D, Zinc. Antibiotics to treat secondary infections. We are using some corticosteroids, though their effectiveness is not documented, nor have I seen them as very effective. IV fluid use is restricted in many cases, for fear of fluid overload. This would have a serious impact on the lungs, but hydration is also important. We keep a pretty close eye on fluids. We have just begun "proning" patients. Encouraging them to lie on their stomachs. This seems to facilitate better lung protection, inflation and hygiene. It is now part of our ICU protocol, and the trend seems to be moving to earlier intervention, on my floor.
