re: Ventilators have been a shitty, 20th century "solution" for a long time.....

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I think the biggest fear of any hospital in all of this was to have a 30 or 40 year old come in and temporarily need a vent and have to arbitrarily take a 85 year old off the vent against their wishes but it seems like many on this board such as OP seem to have a philosophy of vent for me no vent for thee.

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Correct... It’s the younger pt’s that the toughest decisions.

It's my understanding that vents often destroy the lung tissue of the patient through sheer force. This is part of the reason people dont typically recover once they're on one.

The absolute right thing would be to move the vent to the younger person who had a higher chance of survival. I just don’t think it’s a situation that anyone wants to be put in. The doctor, the hospital, and yes the governors and ultimately the president.

Yeah the 40,000 comment was a MASSIVE overstatement but IF there was a place that was gonna exceed vent capacity it would be NYC.


The result is the opposition to cuomo now us going to the opposite of him and arguing against the vent. Just like the press with trump, if someone on the far left says jumping off a cliff is bad then we will get topics on this board extolling the virtues of cliff diving.

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It's my understanding that vents often destroy the lung tissue of the patient through sheer force. This is part of the reason people dont typically recover once they're on one.

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Ventilator pressures can be adjusted, If you require such high pressures to properly ventilate someone (get enough volume into the lungs) then there is already an underlying issue internally. It sounds like a chicken or egg first question but shouldn't be. There will be a million studies after this...I'll be curious to see them.

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Isn’t that essentially what we are dealing with in this scenario? Isn’t this virus damaging lungs?

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Some are making the argument that it is the ventilator doing the damage...not that the damage is done by the virus.

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Isn’t that essentially what we are dealing with in this scenario? Isn’t this virus damaging lungs?

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This an acute thing, I’m basically speaking of people with chronic lung disease.. Copd, pt with emphysema, bronchitis, bronchiectisis etc..

There’s studies out there that suggest it’s not a lung thing but a blood thing.

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In the last 3–5 days, a mountain of anecdotal evidence has come out of NYC, Italy, Spain, etc. about COVID-19 and characteristics of patients who get seriously ill. It’s not only piling up but now leading to a general field-level consensus backed up by a few previously little-known studies that we’ve had it all wrong the whole time. Well, a few had some things eerily correct (cough Trump cough), especially with Hydroxychloroquine with Azithromicin, but we’ll get to that in a minute. There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required… They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease. The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue. Here’s the breakdown of the whole process, including some ELI5-level cliff notes. Much has been simplified just to keep it digestible and layman-friendly. Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs. When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere. Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons: 1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo.. it is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin.

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Some are making the argument that it is the ventilator doing the damage...not that the damage is done by the virus.

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Yes, because if the higher O2 required. O2 will eventually become toxic to the body.. Lower O2 percentages usually won’t..

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There’s studies out there that suggest it’s not a lung thing but a blood thing.

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Hyperbarics is not my thing but seems like someone would have tried it by now, at least on some of the less (less being not just now needing a vent) critical patients. I know some of these hospitals have chambers.

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Hyperbarics is not my thing but seems like someone would have tried it by now, at least on some of the less (less being not just now needing a vent) critical patients. I know some of these hospitals have chambers.

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Problem is in the blood... You can give them all the Oxygen with different pressures, if o2 no longer has an affinity to the hemoglobin, it won’t be affective. I’m hearing some are being treated with blood transfusions..