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<blockquote data-quote="zubenelgenubi" data-source="post: 4684264" data-attributes="member: 63706"><p>Orly?</p><p></p><p>[URL unfurl="true"]https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/[/URL]</p><p></p><p>"But one of the most severe consequences of Covid-19 suggests another reason the ventilators aren’t more beneficial. In acute respiratory distress syndrome, which results from immune cells ravaging the lungs and kills many Covid-19 patients, the air sacs of the lungs become filled with a gummy yellow fluid. “That limits oxygen transfer from the lungs to the blood even when a machine pumps in oxygen,” Gillick said.</p><p></p><p>As patients go downhill, protocols developed for other respiratory conditions call for increasing the force with which a ventilator delivers oxygen, the amount of oxygen, or the rate of delivery, she explained. But if oxygen can’t cross into the blood from the lungs in the first place, those measures, especially greater force, may prove harmful. High levels of oxygen impair the lung’s air sacs, while high pressure to force in more oxygen damages the lungs."</p><p></p><p>"Because U.S. data on treating Covid-19 patients are nearly nonexistent, health care workers are flying blind when it comes to caring for such confounding patients. But anecdotally, Weingart said, 'we’ve had a number of people who improved and got off CPAP or high flow [nasal cannulas] who would have been tubed 100 out of 100 times in the past.' What he calls 'this knee-jerk response' of putting people on ventilators if their blood oxygen levels remain low with noninvasive devices 'is really bad. … I think these patients do much, much worse on the ventilator.'”</p><p></p><p>[URL unfurl="true"]https://www.wpr.org/almost-death-sentence-how-wisconsin-doctors-peers-are-rethinking-ventilators-coronavirus[/URL]</p><p></p><p>"Gattinoni wrote that about 20 percent to 30 percent of the patients examined had severe symptoms, with stiff and heavy lungs that should be treated with ventilators under ARDS protocols to alleviate dangerous fluid buildup. But more than half of the patients whose records Gattinoni examined showed less severe symptoms, with thin, elastic lungs that did not fit the ARDS profile. Treating those symptoms with a ventilator could prove deadly, Gattinoni said in an interview.</p><p></p><p>Mechanical ventilators are highly invasive. Using them involves inserting a tube through a patient’s mouth — a procedure called "intubation" — and forcing air into the lungs. The traditional ARDS ventilator methods could apply too much high pressure to the lungs, potentially causing serious damage'</p><p></p><p>"And this is what’s happened, I’m afraid, in New York,' Gattinoni said."</p><p></p><p>[URL unfurl="true"]https://www.washingtonpost.com/health/2020/04/22/coronavirus-ventilators-survival/[/URL]</p><p></p><p></p><p>"A total of 1,151 patients required mechanical ventilators. Of the 320 for whom final outcomes are known (either death or discharge), 88 percent died. That compares with about 80 percent of patients who died on ventilators before the pandemic, according to previous studies — and with the death rate of about 50 percent that some critical-care doctors had optimistically hoped for when the first cases were diagnosed."</p><p></p><p>[URL unfurl="true"]https://www.google.com/amp/s/www.lmtonline.com/local/amp/Local-doctors-using-ventilators-as-last-resort-15546924.php[/URL]</p><p></p><p>"Cervantes believes ventilators are exacerbating the problems for COVID-19 patients and making it harder for them to recover, even killing them. Intubated patients are often in the hospital for much longer, he said, and the longer they’re in the less likely they are to leave."</p><p></p><p></p><p>And [USER=18222]@Old Man Jingles[/USER] remember when I was talking about potentially repurposing cpap and bipap machines. Apparently I was on the right track, and they wouldn't have needed to be altered.</p><p></p><p>"Researchers and clinicians on the front lines are trying. In a small <a href="https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00653-z" target="_blank">study</a> last week in Annals of Intensive Care, physicians who treated Covid-19 patients at two hospitals in China found that the majority of patients needed no more than a nasal cannula. Among the 41% who needed more intense breathing support, none was put on a ventilator right away. Instead, they were given noninvasive devices such as BiPAP; their blood oxygen levels 'significantly improved' after an hour or two."</p></blockquote><p></p>
[QUOTE="zubenelgenubi, post: 4684264, member: 63706"] Orly? [URL unfurl="true"]https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/[/URL] "But one of the most severe consequences of Covid-19 suggests another reason the ventilators aren’t more beneficial. In acute respiratory distress syndrome, which results from immune cells ravaging the lungs and kills many Covid-19 patients, the air sacs of the lungs become filled with a gummy yellow fluid. “That limits oxygen transfer from the lungs to the blood even when a machine pumps in oxygen,” Gillick said. As patients go downhill, protocols developed for other respiratory conditions call for increasing the force with which a ventilator delivers oxygen, the amount of oxygen, or the rate of delivery, she explained. But if oxygen can’t cross into the blood from the lungs in the first place, those measures, especially greater force, may prove harmful. High levels of oxygen impair the lung’s air sacs, while high pressure to force in more oxygen damages the lungs." "Because U.S. data on treating Covid-19 patients are nearly nonexistent, health care workers are flying blind when it comes to caring for such confounding patients. But anecdotally, Weingart said, 'we’ve had a number of people who improved and got off CPAP or high flow [nasal cannulas] who would have been tubed 100 out of 100 times in the past.' What he calls 'this knee-jerk response' of putting people on ventilators if their blood oxygen levels remain low with noninvasive devices 'is really bad. … I think these patients do much, much worse on the ventilator.'” [URL unfurl="true"]https://www.wpr.org/almost-death-sentence-how-wisconsin-doctors-peers-are-rethinking-ventilators-coronavirus[/URL] "Gattinoni wrote that about 20 percent to 30 percent of the patients examined had severe symptoms, with stiff and heavy lungs that should be treated with ventilators under ARDS protocols to alleviate dangerous fluid buildup. But more than half of the patients whose records Gattinoni examined showed less severe symptoms, with thin, elastic lungs that did not fit the ARDS profile. Treating those symptoms with a ventilator could prove deadly, Gattinoni said in an interview. Mechanical ventilators are highly invasive. Using them involves inserting a tube through a patient’s mouth — a procedure called "intubation" — and forcing air into the lungs. The traditional ARDS ventilator methods could apply too much high pressure to the lungs, potentially causing serious damage' "And this is what’s happened, I’m afraid, in New York,' Gattinoni said." [URL unfurl="true"]https://www.washingtonpost.com/health/2020/04/22/coronavirus-ventilators-survival/[/URL] "A total of 1,151 patients required mechanical ventilators. Of the 320 for whom final outcomes are known (either death or discharge), 88 percent died. That compares with about 80 percent of patients who died on ventilators before the pandemic, according to previous studies — and with the death rate of about 50 percent that some critical-care doctors had optimistically hoped for when the first cases were diagnosed." [URL unfurl="true"]https://www.google.com/amp/s/www.lmtonline.com/local/amp/Local-doctors-using-ventilators-as-last-resort-15546924.php[/URL] "Cervantes believes ventilators are exacerbating the problems for COVID-19 patients and making it harder for them to recover, even killing them. Intubated patients are often in the hospital for much longer, he said, and the longer they’re in the less likely they are to leave." And [USER=18222]@Old Man Jingles[/USER] remember when I was talking about potentially repurposing cpap and bipap machines. Apparently I was on the right track, and they wouldn't have needed to be altered. "Researchers and clinicians on the front lines are trying. In a small [URL='https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00653-z']study[/URL] last week in Annals of Intensive Care, physicians who treated Covid-19 patients at two hospitals in China found that the majority of patients needed no more than a nasal cannula. Among the 41% who needed more intense breathing support, none was put on a ventilator right away. Instead, they were given noninvasive devices such as BiPAP; their blood oxygen levels 'significantly improved' after an hour or two." [/QUOTE]
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