NY physician with a potentially very important message about Covid-19 and lungs

[jeffreyi]

Apologies if a duplicate





https://vimeo.com/402537849?ref=em-share

[Skittles]

1. could you move the link so we can see it

I want to send this to someone, thanks

[jeffreyi]

4. I'm not sure how to do that,

The video seems to want to display over the link info.

You can copy the link from inside the video, I think.

[janterry]

2. He was interviewed and that was posted on Medscape last week

Interview on 6th-April

https://www.medscape.com/viewarticle/928156#vp_3

I think these discussions are active and evolving (so this vimeo is pretty dated, which is an interesting statement itself).

[jeffreyi]

3. Didn't realize it was already a month old. I wonder if there is an update.

[janterry]

15. Lots of discussion in the current medscape

Can you see the article? (I have an account, not sure if you can see it if you don't)

https://www.medscape.com/viewarticle/928605?nlid=135026_3901&src=wnl_newsalrt_200413_MSCPEDIT&uac=60187AG&impID=2345427&faf=1#vp_2

[LisaL]

5. The patients do have pneumonia per the X-rays.

Described as "ground glass opacity" in the lungs. That said, normal ventilator pressure might be too much for them.

[hlthe2b]

8. Frequently both. There is a dogma about ventilator use: intubate early and high pressure which is

being questioned here. I think as more hospitals are delaying intubation more so out of necessity or patient (especially infected HCW demands) and using BPAP under high Oxygen flow through nasal canulas, we may well have an internal comparison.

He's right that it is hard to break against Pulmonologists' established protocol, which in the case of COVID-19 may well be at least partially wrong.

[safeinOhio]

6. Might this work. Everything old, becomes new again, so

An iron lung, known in medical terms as a negative pressure ventilator, is a piece of equipment that helps a person breathe. The machinery features pressurized cylinders which create a vacuum to push oxygen into a person's lungs.

[gristy]

7. that sure would seem to be a lot less uncomfortable

And it produces better outcomes too, at least for COPD.

https://www.ncbi.nlm.nih.gov/pubmed/15065832

Abstract
The aim of this randomised study was to compare the effects of iron lung ventilation (ILV) with invasive mechanical ventilation (IMV) in patients with acute respiratory failure (ARF) due to exacerbation of chronic obstructive pulmonary disease. Forty-four patients with ARF were assigned either to ILV (22 patients) or IMV (22 patients). Primary end-points were the improvement in gas exchange and complications related to mechanical ventilation. On admission ILV and IMV groups did not differ in age, simplified acute physiology score II, arterial oxygen tension (Pa,O2)/inspiratory oxygen fraction (FI,O2), arterial carbon dioxide tension (Pa,CO2) and pH. Compared with baseline, ILV and IMV induced a similar and significant improvement in Pa,O2/FI,O2, Pa,CO2 and pH after 1 h of treatment and at discontinuation of mechanical ventilation. Major complications tended to be more frequent in patients treated with IMV than in those treated with ILV (27.3% versus 4.5%), whereas mortality rate was similar (27.3% versus 18.2%). The ventilator-free days and the length of hospital stay were significantly lower in the ILV than in the IMV group. This study suggests that iron lung ventilation is as effective as invasive mechanical ventilation in improving gas exchange in chronic obstructive pulmonary disease patients with acute respiratory failure, and is associated with a tendency towards a lower rate of major complications.

[safeinOhio]

12. Of course producing new iron lung would be difficult, but

a simple one made from modern plastic and produce with 3D printing may be the ticket.

[gristy]

14. They make pvc pipe in diameters up to 60"

http://www.harrisonplastic.com/aboutpvc.html

You'd need a sliding track for patient ingress/egress, and a well-sealed door at the end with a hole for his/her head.
And then of course a machine that pressurizes/depressurizes the chamber at a regular breathing rate.

Surely people are working this angle...

[in2herbs]

9. If this is true, why wouldn't those portable, home-based oxygen-making machines work? nt

[Baitball Blogger]

10. Why is there no easy copy link for this video?

[Baitball Blogger]

11. He's talking about Decompression Sickness.

Isn't there a counter to these symptoms?

[safeinOhio]

13. In airplanes, it's the oxygen mask

that drops down.

[OhioChick]

16. Shared this video with my kids

They said they're seeing the same thing as this doctor is describing.

[uponit7771]

17. WOW !! I thought the respirator was used to TREAT oxygen the lack of oxygen. I never questioned it

... and thought about why respirator were used on people who could breath already.

That's why the UK PM was put on oxygen ... jus damn