Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
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Anonymous
Does your brother have a theory? |
Anonymous
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Video reveals lung damage in US coronavirus patient: 'People need to take this seriously'
George Washington Hospital video on CNN https://www.cnn.com/2020/03/26/health/covid-19-lung-damage-video/index.html Another video:.. In a new video, lung pathologist Sanjay Mukhopadhyay, MD, lays out in detail how the lungs are affected in these severe cases. The 15-minute video walks through how COVID-19 causes a “dangerous and potentially fatal” condition known as acute respiratory distress syndrome (ARDS) while providing stark images that underscore the severity of the damage that condition can cause to your lungs. What’s the connection between coronavirus and ARDS? As Dr. Mukhopadhyay explains, Chinese researchers have linked COVID-19 to ARDS. Their study examined risk factors for 191 confirmed coronavirus patients who died while being treated in two hospitals in Wuhan, China. The researchers found 50 of the 54 patients who died had developed ARDS while only nine of the 137 survivors had ARDS. “It’s a really, really significant contribution to death in these patients,” says Dr. Mukhopadhyay. How can doctors tell if you have ARDS? If you have ARDS, you’ll have symptoms like sudden breathlessness, rapid breathing, dizziness, rapid heart rate and excessive sweating. But the four main things doctors will look for are: If you have an acute condition, symptoms that started within one week of what they call a “known clinical insult,” or new or worsening symptoms. If your shortness of breath isn’t explained by heart failure or fluid overload. Having low oxygen levels in your blood (severe hypoxia). Both lungs appearing white and opaque (versus black) on chest X-rays (called bilateral lung opacities on chest imaging). So how does ARDS actually damage your lungs? Most importantly, patients who are suffering from ARDS end up having damage to the walls of the air sacs in their lungs — the ones that help oxygen pass through into our red blood cells. That’s what doctors term diffuse alvelolar damage. In a healthy lung, oxygen within these air sacs (alveolus) travels through to small blood vessels (capillaries). These tiny vessels, in turn, deliver the oxygen to your red blood cells. “Nature has evolved in a way that the wall of alveolus is very, very thin in a normal person so oxygen can easily get from the air space in between to the red blood cell,” Dr. Mukhopadhyay explains. The coronavirus damages both the wall and lining cells of the alveolus as well as the capillaries. The debris that accumulates because of all of that damage lines the wall of the alveolus the same way paint would cover a wall, Dr. Mukhopadhyay points out. The damage to capillaries also causes them to leak plasma proteins that add to the wall’s thickness. “Eventually, the wall of the alveolus gets thicker than it should be,” he notes. “The thicker this wall gets, the harder it is to transfer oxygen, the more you feel short of breath, and the more and more you start moving towards severe illness and possibly death.” Why is understanding how COVID-19 affects your lungs important? The whole point, Dr. Mukhopadhyay stresses, is to emphasize what the coronavirus is capable of doing to a body, particularly high-risk patients who may be more vulnerable to infection. He hopes this will get people to take the current outbreak seriously. “Please don’t dismiss this as ‘just another viral infection that will pass,'” he says. “Please take all the precautions that the CDC is outlining. Please protect yourself, your family, and others.” |
Anonymous
In general terms, "something" happens in some people that triggers an often fatal immune response. He doesn't seem to have theories about what, specifically. Which is what worries him. Initially based on early reporting, he was pretty laid back about this all. But as more stats are out and now he's seeing things first-hand, he's very concerned. Yes, many of those who die are "high risk." But then there are enough relatively young people without known issues who have this response, too and end up dying. |
Anonymous
Thank you. Do you think the medications they took at the beginning of the symptoms could have an impact? Some are known to interfere with the outcome. Do the doctors like your brother has time and resources to check what self medication the patients did. For instance things like Aspirin or Advil.. etc.. those are not good to take.. also cough suppressants? I just wonder if anyone looks into this case by case. |
Anonymous
You do realize that the birds do not have a pilot license yet it does no stop them from flying. |
Anonymous
DP It's more like building airplanes than flying. If you don't have the training, you don't understand why you can't intuit your way through it. Dunning-Kruger effect. |
Anonymous
I asked him about this because as a migraineur, I turn to ibuprofen and naproxen sodium regularly and was worried. He was not concerned about these medications at all--a lot of misinformation and panic led to the advice to avoid ibuprofen. He thinks that's tragic not only because it's not true re: COVID, but more people will take acetaminophen and end up with liver failure. When I asked if I should avoid ibuprofen or naproxen sodium because of COVID, he said no. He's not a fan pretty much ever of cough suppressants. |
Anonymous
I am sure he is familiar with the 2019 Novel Coronavirus and Cytokine Storm https://lab-a-porter.com/2020/02/wuhan-coronavirus-and-cytokine-storm/ . This “cytokine storm” can trigger a viral sepsis in coronavirus infection, where viral replication and excessive, uncontrolled systemic inflammation can lead to pneumonitis, acute respiratory distress syndrome, respiratory failure, shock, organ failure, secondary bacterial pneumonia, and potentially death. This same correlation between cytokine storm and severity of illness was observed previously in both SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) patients. The 2019-nCoV has a possible asymptomatic incubation period for up to 2 weeks, though who were infected often experience dry cough and fatigue. While the carrier can transmit the virus to others during this incubation, fever and the development of viral pneumonia follows. |
Anonymous
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I wonder if the Cytokinetic shock is not as much result of immunoresponse as much as a domino effect.
First go lungs.. all swollen and infected.. they can not keep up with the oxygen infusion of blood.. so then heart does not have enough of oxygen .. so it does not pump strong enough and so all organs don't have enough blood to function properly.. so kidneys do not do their job.. neither the liver and other organs so gradually all the stuff that should be outside of the body it is still inside. The toxins build up creates a perfect storm for sepsis like infection.. and there you have your cytokinetic shock. .. What if a CV patients with severe lung problems would be put immediately on dialyses to also clean their blood? Just thinking illegally since I am not a med doctor and someone told us here that NOBODY who is not a doctors should have any ideas how medicine works or any theories how to save lives. 
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Anonymous
You would be surprised what I can intuit. You underestimate the mind that is NOT limited to think inside the box. Do you know that MOST geniuses do not have the training you are talking about? The brilliant mind can see from the above like an eagle, whereas the trained minds see like a person cutting through the jungle. |
Anonymous
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It's good to post it now, because the GOP created this crisis by fighting a war on experts for five decades. And why does the GOP hate scientists and experts? Because scientists talk about pesky things like global warming that make it hard for GOP-donor oil and gas CEOs to make maximum profit. It's not a coincidence that Charles Koch is an oil and gas CEO, that he's a big GOP donor, and that he funds a war on expertise. |
Anonymous
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I do not think there is de novo intuition into detailed respiratory pathophysiology happening here, but YMMV.,
On another note, be careful of homemade PPE. Not the cloth masks -- that isn't a problem. But homemade PAPR and N95 style equipment has been linked to dangerous hypercapnia as well as not being effective. The training does appear to make a difference. |
Anonymous
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... and that war on expertise means GOP donors tried to cut the CDC's budget and succeeded in muzzling CDC scientists and making it hard for the CDC to hire and retain talent.
This whole lockdown could have been avoided. It would have been avoided if Obama was president. Because Democrats actually care about running the government well - they understand the government is the way we achieve social goals, like protecting the public health. Charles Koch is happy to take tax cuts, but he ain't going to help anyone in this crisis. |
Anonymous
My friend.. my thought will pass by yours so fast, you wont even know what just happened. Doppler effect. |
Anonymous
You are lucky if you get migraines and that's all you have to take. |