The Sat Report: Pope Francis suffers two episodes of acute respiratory failure, back on mechanical ventilation

Let us pray for Pope Francis, he needs our prayers

I am just going to cut to the chase, the Holy Father is very sick, and things took a turn for the worse today, with the Pope having two episodes of acute respiratory failure. The cause of the respiratory failure, we were told, was the accumulation of mucus in the major air passages in the lungs - a consequence of pneumonia- which had to be cleared by bronchoscopy, twice. The Pope is stable, alert, and orientated, but requires non-invasive mechanical ventilation to maintain his blood oxygen concentrations.

This is now the third serious downturn the Pope has suffered since he was admitted to hospital 18 days ago with bronchitis. At this point, and with the limited information that we have, if the Holy Father survives this admission it will be miracle. Miracles do happen.

The Holy Father on February 14th, the day of admission to hospital (Vatican Media)

Respiratory failure occurs when the lungs cannot adequately provide oxygen to the body leading to what is termed hypoexmia, very low levels of oxygen in the blood. A second type of respiratory occurs when this is coupled with the inability of the lungs to remove carbon dioxide from the body. We don’t know which of the two the Pope suffered today.

Thus far in this admission the Holy Father has undergone three bronchoscopies, which are very invasive medical procedures to try to clear mucus in the lungs of a patient who isn’t able to clear the mucus themselves. The Holy Father is very sick and 88 years old. Now I don’t want to alarm anyone reading this, but in my professional opinion I don’t really know if this is appropriate thing to do given the Pope’s clinical scenario. At the moment it does seem that the doctors are putting the Holy Father through significant pain and suffering for a procedure that is unlikely to do anything other than postpone death.

This may be the wishes of the Holy Father though, who may want doctors to try absolutely everything. The Italian medical culture, for lack of a better phrase, does seem to employ a more aggressive treatment regimen in order to try to achieve cure in the elderly and dying than most other countries by far.

Additionally, the Vatican said that the Pope was alert throughout bronchoscopies, which to me doesn’t make any sense, unless the doctors feel that he is too weak for sedation, i.e there is a serious risk of death if they were to sedate him for the procedure. I don’t know, and perhaps it is imprudent to speculate.

The Pope is back on non-invasive mechanical ventilation, most probably on a BiPAP machine. The big fear is what happens if the Pope develops further, more frequent, respiratory crises. Is the plan to step up the care further with invasive mechanical ventilation and admission to an intensive care unit, or is it palliation? We really don’t know, but these are some of the things that the Pope must have already discussed with the doctors treating him.

In other, more good news, which wasn’t mentioned in the Vatican’s press release, the Holy Father’s blood markers are still stable. No leukocytosis (high white blood cell count), so unlikely to develop aspiration pneumonia at this point from the vomit he inhaled last Friday.

I apologise for being the bearer of bad news, but the Pope's clinical condition is very complex, and we need to pray for him.

Here is today’s statement from the Holy See Press Office in full:

“Today, the Holy Father suffered two episodes of acute respiratory failure, caused by a significant accumulation of endobronchial mucus and consequent bronchospasm.

Two bronchoscopies were therefore performed, with the need to remove large secretions.

In the afternoon, non-invasive mechanical ventilation was resumed. The Holy Father remained alert, oriented and cooperative at all times.

The prognosis remains guarded.”

This evening the eight of the nightly rosaries for the health of Pope Francis has held in St. Peter’s Square, tonight led by Robert Francis Cardinal Prevost, Prefect of the Dicastery for Bishops, with the some of the Roman Curia and most of the other Cardinals resident in Rome in attendance.

Let us all please continue to pray for the Pope, whose condition is critical, during this very trying time for him.

Oremus pro Pontifice nostro Francisco. Dominus conservet eum, et vivificet eum, et beatum faciat eum in terra, et non tradat eum in animam inimicorum eius.