Treating COVID-19 patients presents myriad challenges, says ICU director

Dr. Ronen S. Dudaie (right) is director of the intensive care unit at SSM Health St. Mary’s in Richmond Heights and SSM Health DePaul Hospital in Bridgeton.

By Ellen Futterman, Editor

As director of the intensive care unit at SSM Health St. Mary’s in Richmond Heights and SSM Health DePaul Hospital in Bridgeton, Dr. Ronen S. Dudaie sees the sickest of the sick, even in normal times. Nevertheless, he says, dealing with patients infected with the coronavirus has been enormously challenging because there is no standard treatment, and cases can vary significantly.

“Suddenly, we’re dealing with a new disease that has high mortality that we weren’t ready for emotionally. I’ve never seen anything like this,” said Dudaie, 53, who grew up in Haifa, Israel, before moving to the United States in 2005 and the St. Louis area in 2015. “Most of our COVID patients admitted to the ICU have very high oxygen requirements. The majority require mechanical support like a ventilator or a machine that breathes for you. A small amount will be on a BiPAP, which is a mask that covers the nose and mouth and provides you with positive pressure to help you breathe.

“We do our very best to minimize complications because once a patient has complications they usually don’t do very well.”

Most of Dudaie’s patients are older and many have pre-existing conditions that put them at greater risk once they contract COVID. One patient, however, who made an indelible impression, was the first person with COVID the doctor treated at St. Mary’s. She was a woman in her 30s who had no comorbidity but was extremely overweight.

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“She didn’t survive,” he said. “We tried everything, but we couldn’t help her.”

Dudaie, a married father of three who lives in Chesterfield, says there have been about 100 COVID patients at DePaul and 40 or so at St. Mary’s. He has concerns about a “second wave” of cases as the economy reopens, especially among the elderly and people with comorbidities. 

“The name of the game is to control the infectious rate,” he said. “I hope we get people educated and in the next six months come up with a vaccination. It’s already in the works. There is no other treatment actually working (for everyone).”

Asked if any bright spots have resulted from this pandemic, he says it’s the support he and his colleagues have gotten from the community and its appreciation for what they are doing. 

“The fact that a lot of my nurses and my team have stepped up and are so committed to doing everything they can for these patients is very satisfying,” he said, adding that many are working extra shifts. “I take solace in the solidarity.”