Posted on 04/08/2020 6:08:52 PM PDT by CaptainK
Even as hospitals and governors raise the alarm about a shortage of ventilators, some critical care physicians are questioning the widespread use of the breathing machines for Covid-19 patients, saying that large numbers of patients could instead be treated with less intensive respiratory support.
If the iconoclasts are right, putting coronavirus patients on ventilators could be of little benefit to many and even harmful to some.
What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen.
That is making critical care physicians suspect that blood levels of oxygen, which for decades have driven decisions about breathing support for patients with pneumonia and acute respiratory distress, might be misleading them about how to care for those with Covid-19. In particular, more and more are concerned about the use of intubation and mechanical ventilators. They argue that more patients could receive simpler, noninvasive respiratory support, such as the breathing masks used in sleep apnea, at least to start with and maybe for the duration of the illness.
“The patients in front of me are unlike any I’ve ever seen,” Kyle-Sidell told Medscape about those he cared for in a hard-hit Brooklyn hospital. “They looked a lot more like they had altitude sickness than pneumonia.”
(Excerpt) Read more at statnews.com ...
https://www.thoracic.org/patients/patient-resources/resources/what-is-ecmo.pdf
Interesting.
I was in an ICU for a few days in the last 6 months but it didn’t seem at all different from being in a regular hospital room.
Ventilators can damage the lungs but we have learned how to use them with little or no damage by adjusting tidal volumes and pressures. By the time you are on a vent the lungs are already not working well, that is why you are on the vent in the first place.
It may not seem different to a layman but there is a huge difference. There is a myriad of wiring and monitors to support the equipment needed. The physical room is often larger to support the amount of personnel and equipment. The water supply has to be adequate for dialysis. There is a lot going on under the surface you don’t see
OK.
The doctor’s part was interesting but I thought you linked me for the end part.
Oxygen hyperbaric chambers...
Come to mind...
Had a job offer long ago to do those...Was incredibly boring...
You have no idea what you are talking about...in regard to ventilators....I actually do....
No idea about your comment..about drugs and knives...
Don’t try....he doesn’t listen..and knows everything.
They don’t want to admit Trump was right about the use of the drug to fight the Wuhan Flu so people may die of it so the shameless RATS can use it as a political talking point. These people are beyond evil!
And their lungs were pretty good....It was just support....
Go back to Waco....
Note: COVID-19 patients have damaged lungs.
It is generally regarded, based on animal models and human studies, that volutrauma is the most harmful aspect of mechanical ventilation.[2][3][4] This may be regarded as the over-stretching of the airways and alveoli.
During mechanical ventilation, the flow of gas into the lung will take the path of least resistance. Areas of the lung that are collapsed (atelectasis) or filled with secretions will be underinflated, while those areas that are relatively normal will be overinflated. These areas will become overdistended and injured. This may be reduced by using smaller tidal volumes.[5][6]
During positive pressure ventilation, atelectatic regions will inflate, however, the alveoli will be unstable and will collapse during the expiratory phase of the breath (atelectotrauma). This repeated alveolar collapse and expansion (RACE) is thought to cause VALI. By opening the lung and keeping the lung open RACE (and VALI) is reduced.[7]
Another possible ventilator-associated lung injury is known as biotrauma. Biotrauma involves the lung suffering injury from any mediators of the inflammatory response or from bacteremia.
Finally oxygen toxicity contributes to ventilator-associated lung injury through several mechanisms including oxidative stress.
Possible reasons for predisposition to VALI include:
An injured lung may be at risk for further injury
Cyclic atelectasis is particularly common in an injured lung
“Go back to Waco”
Never been to Waco!
My recollection is that the room was smaller, the turlet was under a small roll-away box right next to the bed.
There was a large ante-room, then the hall.
I had no machines beyond a ubiquitous hospital IV infuser.
My understanding is that in the ICU there is a higher ratio of nurses/patient. That’s about it in my case.
“I was in an ICU for a few days in the last 6 months but it didn’t seem at all different from being in a regular hospital room.”
The ICU is set up for Oxygen and ventilators. Most COVID patients that go to ICU will also go on a ventilator.
Note NOT all COVID-19 positive patients have damaged lungs.........
You can keep spending your time spreading BS...Most people here ignore you...
You will have the last word...
The efficient frequency for wireless monitoring of the electrical outputs from heart and lungs is 60gHz for detection of Hz in the body. The Hz of tissues in the body varies widely, but it was found that 60gHz was the most useful frequency for wireless monitoring.
There are machines for measuring that?
Once again...you have no idea what you are talking about....
Why do you do this stuff..??
Site some stats or something...just don't pull it out of your ass.
Administer nitric oxide (NO)? You nose and sinuses deliver NO to the lungs, which is why you should always breathe through your nose.
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