ROUEN, France (AP) – Slowly choking in a French intensive care unit, Patrick Aricique feared that he would die of his ailing lungs that were ‘completely burned from the inside, burned like the cathedral in Paris’ as weary doctors and nurses worked all day and night to keep critically ill COVID-19 patients like him alive.
A married couple in the same ICU died within hours of each other as Aricique, who felt as vulnerable as ‘a bubble ready to burst’, and was also struggling with the coronavirus. The 67-year-old retired contractor gives him a divine hand for his survival. “I saw archangels, I saw little angels,” he said. “It was as if I was communicating with the afterlife.”
At his side were French medical professionals who drew on the bitter experiences of previous waves of infection, now fights relentlessly to keep patients awake and turn off mechanical respirators when possible. They treated Aricique with nasal tubes and a mask that bathed his heaving lungs in a constant stream of oxygen. That saved him the discomfort of a thick breathing tube deep in his throat and heavy sedation that patients often – sometimes rightly – fear will never wake up.
While mechanical ventilation is unavoidable for some patients, it is now a less systematic step than at the start of the pandemic. Dr. Philippe Gouin, head of the ICU unit where Aricique was treated for severe COVID-19, said, “We know that every tube we insert is part of complications, prolongations of stay and sometimes morbidity.”
About 15% to 20% of his intubated patients do not survive, he said.
“It’s a milestone that weighs on survival,” said Gouin. “We know that we will lose a certain number of patients that we cannot help negotiate this angle.”
The shift to less invasive respiratory treatments is also helping French ICs avoid collapse amid a renewed buzz of coronavirus cases. Overloaded by a more contagious virus variant that first ravaged neighboring Britain, the third wave of infection in France has pushed the country’s COVID-19-related death toll above 100,000 people.Hospitals across the country are once again grappling with the macabre math to make way for thousands of critically ill patients.
“We have a continuous stream of cases,” said Dr. Philippe Montravers, head of the ICU at Bichat Hospital in Paris, where patients are again being horned in makeshift intensive care units. “Each of these cases are absolutely horrifying stories – for the families, for the patients themselves, of course, for the responsible doctors, for the nurses.”
Sedated patients kept alive on mechanical ventilation often occupy their IC beds for several weeks, even months, and the physical and mental trauma of their afflictions can take months longer to heal. But 13 days after being admitted to ICU care in the Norman cathedral city of Rouen, Aricique had recovered enough for another critically ill patient to take his place.
A noninvasive nasal ventilation system that delivers thousands of liters (hundreds of gallons) of life-sustaining oxygen every hour got him through the worst of his infection until he was good enough to reduce the flow to a trickle and sit upright, his New Testament Bible at his side. silk. Aricique had a small lunch of omelette and red cabbage to rebuild his strength and said he was feeling cheerful. A nurse freed him from drops stuck in the arms, wrapping the tubes like guts.
Dr. Dorothee Carpentier made rounds with young doctors and nurses in tow and allowed herself a mini party as she raced past Aricique’s room, after declaring him fit for discharge. The patient in the adjoining room could also leave, she decided. She described the impending departure as “minor victories” for the entire 20-bed ward, a temporary setup in what was previously a surgical unit and now completely converted for C0VID-19 care.
“I imagine they’ll be filled up again in the morning,” Carpentier said of the two vacant beds. “The tricky thing about this third wave is that there is no stop button. We don’t know when it will start to slow down. ”
Down the hall, a 69-year-old woman placed face-down on her stomach struggled with the effort of breathing with an oxygen mask and getting dangerously close to the point where doctors would decide to numb and intubate her. Nurse Gregory Bombard recruited the woman’s visiting daughter-in-law in an effort to avert that next step and made it clear to her the importance of sticking with the mask.
“Morale is so important, and she has to turn this corner,” said Bombard. “We do what we can. They also have to make the effort to win or they lose. “
“Do what you can,” the nurse said to the daughter-in-law.
The relative later emerged from the patient’s room with blurred eyes and shaken.
“It’s really hard to see her like this,” she said. “She lets herself go.”
In another room, Gouin softly begged a 55-year-old market stall operator who complained that his oxygen mask made him feel claustrophobic.
“You have to play the game,” urged the doctor. “My goal is that we don’t get to the point where we have to put you to sleep.”
The patient agreed. “I don’t want to be intubated, in a coma, not knowing when you’ll wake up,” he said.
Intubations can be traumatic for everyone involved. A patient who sobbed when put to sleep remained sedated in the ICU almost two weeks later.
“You could tell he was terrified,” Bombard recalled. “It was horrible.”
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