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Wednesday, September 23, 2020

To improve recovery rate, Punjab doctors bank on High Flow Nasal Oxygen machines

All big hospitals in the state, including government and private, are now equipping themselves with HFNO machines.

Written by Anju Agnihotri Chaba | Jalandhar | Updated: August 24, 2020 11:07:15 pm
Punjab records 38 new cases, 13 of them infected outside statePunjab's recovery rate is 61 per cent against the national average of 74.28 per cent. (Express photo)

Punjab is looking at High Flow Nasal Oxygen (HFNO) machines to improve its Covid recovery rate and arrest the high mortality rate.

Punjab’s recovery rate is 61 per cent against the national average of 74.28 per cent.

All big hospitals in the state, including government and private, are now equipping themselves with HFNO machines. Jalandhar Civil Hospital, which has been converted into a Level-3 facility, has got two such machines, and is waiting to get two more in the coming days. Doctors dealing with coronavirus believe that HFNO machines can prevent putting patients on ventilators, which are now linked to poor survival rate.

One HFNO machine supplies 60 litres oxygen per minute to a patient with respiratory distress and is safe against any secondary infection to the patient whereas there are chances of secondary infection in the use of ventilators.

Level-3 Covid patients require critical care and are referred to ICU/HDU/ventilator facilities. HFNOs are the part of Level-3 facilities.

Dr. Deepak John Bhatti, principal of Guru Gobind Singh Medical College and Hospital, Faridkot, while talking to The Indian Express said, “Though HFNO machines are not a replacement for ventilators but an important stage in one to the three stages required for Level-3 patients, including oxygen mask, HFNO and non-invasive & invasive ventilators. HFNO therapy is quite good during pre-ventilator stage”.

Level-3 patients with respiratory distress require more oxygen and HFNO is much comfortable for them as it supplies large amount of oxygen and can also help patients in breathing, said Dr Bhatti.

He added that they have already got around 10 such machine in their hospital and have placed more demand as “patients are responding well to these machines”.

He further said compared to ventilators, it is easier to wean off patients from them.

“Ventilator should be last resort,” he said.

Experts believe that if patients show good response to HFNO then this treatment should be continued instead putting them on ventilators.

“HFNO machines used for Level-3 patients have shown very good recovery rate and are much better as they prevent seriously ill patients being put on ventilator support directly,” said Dr Rajesh Bhaskar, the state nodal officer for Covid-19, adding that these machines are preferred because the survival rate with ventilator use is poor.

He said that all the major government hospitals with Level-3 facilities are being equipped with this machine.

Though the state Nodal Officer said that they have not collected any data about the recovery rate with HFNOs so far, but he added they have shown good results in the hospitals where these are being used.

Dr Navjot Dahyia, state president of the Indian Medical Association, Punjab, said that these machines are “comfortable” as they can be removed after every a few hours when a patient feels comfortable.

Official sources said that there are approximately over 100 such machines in Punjab currently at both government and private hospitals, but with the more awareness among doctors more demand for HFNOs is being made by doctors.

These machines are 5 to 6 times less costly than the ventilators and for most of the Level-3 patients, who can do without ventilators, these should be used first, said Dahyia.

Further, doctors do not require any special training to handle these while ventilator usage is quite a specialised task.

Meanwhile, there were 51 patients on ventilator and 414 patients on oxygen support, several of them on HFNOs, till August 24.

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