4 ms·

You can use an ECMO instead of ventilation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185806/ Here's

You can use an ECMO instead of ventilation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185806/ Here's a fringe idea in the worse case: Connect one ECMO oxygenator to multiple patients at once using Type-O negative blood. You'd have to filter out the O-negative RBC's as they come in.

blackRust 7y ago
Unfortunately the number of ECMO machines is far cry away from what is required for this to work: https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygen... Even if you manage to double or triple capacity unfortunately it is no match to the exponential growth.
- haldujai 7y ago
  We have a lot more ECMO capacity than people think, CPB machines from heart surgery cases can be used to provide ECMO which are at least an order of magnitude more common than classic ECMO machines.
bryanrasmussen 7y ago
I'm somewhat dense - why Type-O?
- ipostonthisacc 7y ago
  it is somewhat universal. type-O blood can be used for all groups (in general), but type-O patients can only receive own
- aabajian 7y ago
  O-negative means the red blood cells lack the A, B and Rh antigens on their cell membrane. It is these antigens that (most) often lead to a host immune response.
- Spooky23 7y ago
  Type O is the universal donor.
haldujai 7y ago
This is an extremely flawed idea. Not only does transfusion present a big risk, we quote ~20% risk of adverse events (minor to severe), but what you’re suggesting massive transfusion protocol (DIC, hemolysis, TRALI, TACO) AND ECMO which itself is orders of magnitude more dangerous than ventilation. The risks are numerous but for brevity sake you have: Acute limb ischemia, DIC/other coagulopathies and spontaneous hemorrhage which carry huge mortality. It would be way simpler and safer to connect multiple patients to the same ventilator who are all on CMV with similar settings. ECMO is not saving many people with severe COVID-19 related illness. It depends on buying time for your body to recover. Nearly every case I’ve read about that required ECMO the patient died because of multiorgan failure and sepsis. ECMO only works well in patients with isolated lung (and some circumstances heart) problems.
hn_throwaway_99 7y ago
This seems pretty insane to me. ECMO in general is much more dangerous than mechanical ventilation because the risk of infection and sepsis is so much higher. Certainly understand it as a last ditch effort, but the resources and risks WRT ECMO is much higher than mechanical ventilation.

blackRust 7y ago

Unfortunately the number of ECMO machines is far cry away from what is required for this to work: https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygen... Even if you manage to double or triple capacity unfortunately it is no match to the exponential growth.

haldujai 7y ago
We have a lot more ECMO capacity than people think, CPB machines from heart surgery cases can be used to provide ECMO which are at least an order of magnitude more common than classic ECMO machines.

bryanrasmussen 7y ago

I'm somewhat dense - why Type-O?

ipostonthisacc 7y ago
it is somewhat universal. type-O blood can be used for all groups (in general), but type-O patients can only receive own
aabajian 7y ago
O-negative means the red blood cells lack the A, B and Rh antigens on their cell membrane. It is these antigens that (most) often lead to a host immune response.
Spooky23 7y ago
Type O is the universal donor.

haldujai 7y ago

This is an extremely flawed idea. Not only does transfusion present a big risk, we quote ~20% risk of adverse events (minor to severe), but what you’re suggesting massive transfusion protocol (DIC, hemolysis, TRALI, TACO) AND ECMO which itself is orders of magnitude more dangerous than ventilation. The risks are numerous but for brevity sake you have: Acute limb ischemia, DIC/other coagulopathies and spontaneous hemorrhage which carry huge mortality. It would be way simpler and safer to connect multiple patients to the same ventilator who are all on CMV with similar settings. ECMO is not saving many people with severe COVID-19 related illness. It depends on buying time for your body to recover. Nearly every case I’ve read about that required ECMO the patient died because of multiorgan failure and sepsis. ECMO only works well in patients with isolated lung (and some circumstances heart) problems.

hn_throwaway_99 7y ago

This seems pretty insane to me. ECMO in general is much more dangerous than mechanical ventilation because the risk of infection and sepsis is so much higher. Certainly understand it as a last ditch effort, but the resources and risks WRT ECMO is much higher than mechanical ventilation.