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They kept giving reasons why this might not work... * not tested in humans * cross infection potential * different sized people mess it up ... but I see

They kept giving reasons why this might not work... * not tested in humans * cross infection potential * different sized people mess it up ... but I see no reason why any of these things would stop me from using this in the real world. If things are bad enough that we need to do this, then we should be able to find relatively similar sized people. Cross contamination is not a concern when someone is dying here and now and likely has the same disease as the guy next to him who is also dying. Priority 1 is save them. Make their next of kin sign a waver or something, but save them. Lastly, who cares if it hasn't been "tested"? It was used in the real world, in a real life and death scenario, and it worked. I'd absolutely take my chances with it given that the failed option is to pull people off and set it back to single person mode. At least try. Lastly, I would imagine that some common pressure regulation values could be used to compensate for different sized people.

tathougies 7y ago
> Cross contamination is not a concern when someone is dying here and now and likely has the same disease as the guy next to him who is also dying If COVID evolves into multiple strains, then there is a real risk of cross-infection that would make the immune system forced to work harder? Moreover, a lot of the pneumonia deaths are not due to covid itself but rather due to opportunistic infections (often bacterial) that end up causing the pneumonia that causes death. Letting two COVID patients share a ventilator could mean that now one is exposed to a novel bacteria in the other that causes them to develop pneumonia.
- lordnacho 7y ago
  But it doesn't have to be covid patients. There will still be people who need a ventilator but aren't part of the epidemic, freeing up ventilators for covid patients.
  - tathougies 7y ago
    As an example, my aunt just recently had a heart attack about two weeks before this covid stuff and had to be put on a ventilator. While in the ICU she developed an infection from a rare fungal disease that had been in her lungs for a while but suddenly had the opportunity to grow and cause respiratory distress. A lot of people have strange microbes in them that are being held at bay by the immune system. When all of a sudden you expose an already immuno-distressed person to someone else's novel microbes, you risk opportunistic infections, even in non-covid patients. I'm sure they can figure out how to re-use ventilators, but there probably needs to be some kind of assurance so that things can't cross.
  - AntonStratiev 7y ago
    Based on data from China, 97% of the people who need ventilators will die anyway: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30633-4/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... The Ventilator just keeps them alive for a few days, but there are other bodily systems failing and causing death.
mlyle 7y ago
It's not exactly "different sized people mess it up". It's not just different lung capacities, but different lung compliance-- which also changes over the course of disease. Most simple pressure regulators will not fare well in the environment, either, because of the bidirectional flow, etc. The "Y" hack definitely has use, but finding matches and keeping patients matched definitely means we will only be able to use it sparingly.
- fifteenforty 7y ago
  The flow direction issue is partly addressed by the unidirectional valves in many ventilators/anaesthesia machines. The bigger issue is staffing expertise, I fear.
  - cwingrav 7y ago
    True. Unfortunately, there may be a wide amount of practical experience shortly.
russdill 7y ago
Coronavirus destroys lung tissue and weakens the immune system. Then bacteria move in. It's the bacteria that cause the pneumonia. Different people will likely have different bacteria in their lungs.
- MagnumOpus 7y ago
  That is incorrect for most cases. Viral pneumonia is by far the primary cause of lung obstruction in covid-19 patients, and just about all of them are on antibiotics from the start so bacterial pneumonia will have a hard time establishing itself.

tathougies 7y ago

> Cross contamination is not a concern when someone is dying here and now and likely has the same disease as the guy next to him who is also dying If COVID evolves into multiple strains, then there is a real risk of cross-infection that would make the immune system forced to work harder? Moreover, a lot of the pneumonia deaths are not due to covid itself but rather due to opportunistic infections (often bacterial) that end up causing the pneumonia that causes death. Letting two COVID patients share a ventilator could mean that now one is exposed to a novel bacteria in the other that causes them to develop pneumonia.

lordnacho 7y ago
But it doesn't have to be covid patients. There will still be people who need a ventilator but aren't part of the epidemic, freeing up ventilators for covid patients.
- tathougies 7y ago
  As an example, my aunt just recently had a heart attack about two weeks before this covid stuff and had to be put on a ventilator. While in the ICU she developed an infection from a rare fungal disease that had been in her lungs for a while but suddenly had the opportunity to grow and cause respiratory distress. A lot of people have strange microbes in them that are being held at bay by the immune system. When all of a sudden you expose an already immuno-distressed person to someone else's novel microbes, you risk opportunistic infections, even in non-covid patients. I'm sure they can figure out how to re-use ventilators, but there probably needs to be some kind of assurance so that things can't cross.
- AntonStratiev 7y ago
  Based on data from China, 97% of the people who need ventilators will die anyway: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30633-4/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... The Ventilator just keeps them alive for a few days, but there are other bodily systems failing and causing death.

mlyle 7y ago

It's not exactly "different sized people mess it up". It's not just different lung capacities, but different lung compliance-- which also changes over the course of disease. Most simple pressure regulators will not fare well in the environment, either, because of the bidirectional flow, etc. The "Y" hack definitely has use, but finding matches and keeping patients matched definitely means we will only be able to use it sparingly.

fifteenforty 7y ago
The flow direction issue is partly addressed by the unidirectional valves in many ventilators/anaesthesia machines. The bigger issue is staffing expertise, I fear.
- cwingrav 7y ago
  True. Unfortunately, there may be a wide amount of practical experience shortly.

russdill 7y ago

Coronavirus destroys lung tissue and weakens the immune system. Then bacteria move in. It's the bacteria that cause the pneumonia. Different people will likely have different bacteria in their lungs.

MagnumOpus 7y ago
That is incorrect for most cases. Viral pneumonia is by far the primary cause of lung obstruction in covid-19 patients, and just about all of them are on antibiotics from the start so bacterial pneumonia will have a hard time establishing itself.