When Stephen Donelson arrived in the
emergency room, “we had very little hope for
him,” Goff said.
The Midlothian man had undergone an organ
transplant two years earlier, and the immune-
suppressing drugs that prevent rejection of his
new lungs and liver meant his body couldn’t
fight the coronavirus. Goff ’s first challenge:
how to scale back those medicines just enough
for Donelson to battle the virus without
endangering his transplant.
Her second: He was fighting against the
ventilator’s artificial breaths. So Goff deeply
sedated Donelson, paralyzing his muscles to let
the machine do all the work.
Hospital after hospital struggled with balancing
how to get enough air into oxygen-starved
coronavirus patients without further damaging
fragile lungs.
Ventilation is like “blowing air into a sponge and
all the little holes are opening up. Walls between
the holes can be very thin. If you’re putting in a
lot of air, it can damage the lining of those little
holes,” explained Osborn, the St. Louis critical
care specialist.
A trick the doctors shared with each other: Flip
patients over from their backs to their stomachs
— a procedure called proning that takes
pressure off the lungs, which lie closer to the
back. It also helps lower fluid accumulation in
the lungs.
It’s not a one-time fix. Donelson stayed on
his belly about 16 hours a day early on, as his
doctors watched his oxygen levels improve. It’s
also hot and heavy work: Every turn took five or
Image: Tony Gutierrez