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The Covid-19 thread


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A  newscaster doctor was hospitalized recently for Covid.  He said he opted not to use the ventilator.  Apparently, once you get on the ventilator, your chance of survival is just 10 %.  What would you do if you are on Oxygen with Covid and they tell you that the Oxygen is not enough to keep you alive so you should switch to a ventilator?  The newscaster doctor opted not to switch and lived

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4 minutes ago, zzzz said:

A  newscaster doctor was hospitalized recently for Covid.  He said he opted not to use the ventilator.  Apparently, once you get on the ventilator, your chance of survival is just 10 %.

You are put on a ventilator when you can't breathe on your own! What do you think is the survival rate when you can't breathe? That 10% survival chance is bogus.

https://www.politifact.com/article/2020/apr/28/are-88-covid-19-patients-ventilators-dying-its-not/

A new study, which hasn’t gone through peer review yet, has been posted by researchers at Emory University. It looked at 217 critically ill coronavirus patients at facilities in Georgia, which hasn’t been hit as hard as New York City. It found a far lower mortality rate for patients on ventilators: 29.7%.

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There is more to it then just the ventilator or not using a ventilator .

I hear doctors talk about blood clots in the lungs that prevent the oxygen from being absorbed in the lungs. So being on a ventilator is not a cure all from what I understand.

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For Covid patients, it looks like they are put on ventilators even though they CAN breathe on their own.  The problem is they are not getting enough oxygen when they are breathing.  A ventilator is such a case may do more harm.

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18 hours ago, zzzz said:

For Covid patients, it looks like they are put on ventilators even though they CAN breathe on their own.  The problem is they are not getting enough oxygen when they are breathing.  A ventilator is such a case may do more harm.

If you're not getting enough oxygen, you die! So how can a ventilator cause more harm than death? If a patient has adequate oxygen levels with supplemental oxygen, no ventilator is used. 

If a patient is put on a ventilator it is because they are very sick with covid induced pneumonia. They are the sickest of the sick so one would expect the death rate to be higher in this group. The ventilator is not causing deaths. :doah: 

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54 minutes ago, cavanami said:

The problem is...they are not absorbing the oxygen thru their lungs.

No oxygen. You are dead in a few minutes. The ventilator increases the efficiency of oxygen absorption so the portion of lung that is still functional can sustain life.

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1 hour ago, baa99 said:

No oxygen. You are dead in a few minutes. The ventilator increases the efficiency of oxygen absorption so the portion of lung that is still functional can sustain life.

No, it doesn't.

Full Disclosure:  I've been on a ventilator twice.  Once, I was conscious for a good part of the period I was on the machine.  The second time, they kept me out the whole time.

A ventilator assists the patient in moving air, by sucking and blowing.  It has no direct effect whatsoever on oxygen absorption.  Oxygen absorption is a function of oxygen content in the blood and unimpaired gas diffusion across the capillary (very fine blood vessels: they connect arteries to veins) walls in the pulmonary capillary beds (LARGE networks of LOTS of capillary beds in the lungs).

Carbon dioxide buildup triggers the short-of-breath feeling and urge to breathe.  The CO2 can only exit the body by gas diffusion across the capillary walls.  Gases diffuse from higher concentration to lower concentration.

The main muscle for breathing is the diaphragm.  You pull the diaphragm down, it pulls a low-grade vacuum on the pleural chamber, that contains the lungs.  The lungs try to expand, which requires air to flow in.  You push the diaphragm up, it increases the pressure in the cavity, which forces the lungs to blow gas out to the outside world.

If you are in trouble, for any of a number of reasons, you get tired doing this.  Get tired enough, you pass out and stop breathing from the exhaustion.  THIS IS BAD.  It is, obviously, an immediately life-threatening emergency.

Both times, it was because of bronchitis just getting going on pneumonia, that was also exacerbating asthma.

If gas won't diffuse properly, the vent doesn't do any good, and the pressure cycles can damage the lung tissue.  This is bad.

I remember seeing somewhere that someone was working on some sort of lung bypass technology: they plumb something in, that oxygenates the blood externally to the lungs.  Much more invasive than a ventilator, but it gives the healing processes a chance to repair whatever is wrong IN the lungs.

The first time, the critical care doc saw that I was in trouble, headed downhill, and he made the decision to vent me before it became an emergency.  I have a vague memory from Thursday night of red night light, having a REALLY hard time breathing, and about three or four people working VERY HARD AND FAST on me.  (Some time later, my mother told me she woke up from a nightmare, at right about that time, in which she couldn't breathe, and just as she woke up, she heard the sound of a ventilator.  She was a Registered Nurse back in the day, and she knew what a vent sounded like.)  I woke up Friday morning and realized I was on a vent, because of the way it breathed.  I'd once had a SCUBA regulator with a positive pressure inhale characteristic, and the feeling absolutely unique, unmistakeable, and unforgettable.

The second time, it was already an emergency.  They'd just unloaded me from the meat wagon, they were rolling me down the hall to an exam room.  It was Sunday morning, about 1 AM.  I closed my eyes for a moment.  Next thing I knew, no dreams, no subjective time passed, I was on a different surface, and it was Friday morning.  I found out later I'd passed out and stopped breathing there in the hallway.

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39 minutes ago, Specialist said:

  It has no direct effect whatsoever on oxygen absorption.  Oxygen absorption is a function of oxygen content in the blood and unimpaired gas diffusion across the capillary (very fine blood vessels: they connect arteries to veins) walls in the pulmonary capillary beds (LARGE networks of LOTS of capillary beds in the lungs).

You are forgetting the other variable in gas diffusion, pressure.  Temperature is another variable that affects diffusion.

https://oxfordmedicine.com/view/10.1093/med/9780198784975.001.0001/med-9780198784975-chapter-9

 

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