4 ms·

Could you please share any sources? I know they're not used as much now but haven't seen any evidence that they are specifically to blame for deaths. The major

by corin_ 6y ago

Could you please share any sources? I know they're not used as much now but haven't seen any evidence that they are specifically to blame for deaths. The majority conclusion I've seen in Europe about why earlier death rates were so high in some places was that the hospitals were overloaded and therefore didn't have enough capacity (staff, equipment, etc) and therefore some died due to there not being enough ventilators. This isn't my field of expertise so I'm very open to finding out that my impression is wrong, but my gut feeling is that your comment is not accurate.

war1025 6y ago
I don't have any sources at hand, but the explanation I heard is that ventilators are generally used for people who have healthy lung tissue but are unable to breathe properly. Coronavirus weakens the lung tissue, but the ability to breathe (inhale / exhale) is unaffected. Basically the body was forcing people to have shallow breath to preserve the damaged lung tissue and allow it to recover. The ventilator essentially restored their breathing back to full force, which turned people's lungs into soup basically. Makes sense as an explanation to me, but like I said, I don't have any official sources for that.
- saberdancer 6y ago
  People are not put on ventilators for no reason. They are put because their oxygen level is so level that they will die if it deteriorates. People ended up on ventilators after they received maximum possible level of supplementary oxygen. This explanation sounds very implausible and simplistic. When a person has extremely low oxygen level and you are giving them maximum oxygen possible, what can you do? Ventilator or ECMO (which is probably even more dangerous).
  - war1025 6y ago
    This [1] seems to be a fairly representative article of the sort of thing I've seen. Not peer reviewed, but it hardly seems like fringe lunacy. [1] https://elemental.medium.com/how-one-covid-19-doctor-became-a-ventilator-whistleblower-a1c2dbdd1b06 https://elemental.medium.com/how-one-covid-19-doctor-became-...
    - tptacek 6y ago
      Can you provide a source that wasn't written by a (checks notes) magician?
      - war1025 6y ago
        I don't particularly care about the topic, so no.
  - martinald 6y ago
    Not an expert, but as far as I understand with COVID people were not in major distress breathing even with very poor O sats, which is confusing. The standard was to move people with terrible O2 sats at the start of the outbreak to ventilation immedatley, even if they did not seem to bad. That seems to be replaced with providing high levels of O2/CPAP and only moving people to ventilation when that is not sufficient, even if O2 sats would normally indicate ventilation. This is why vent usage is a lot lower this second time round, even with more patients in hopsital.
    - saberdancer 6y ago
      I am not an expert either. I would be surprised if they put someone on a ventilator just because his O2 level was low without first putting him on O2 and maxing out the flow. Little experience that I do have is that people are first put on O2, then if their saturation remains low they increase the flow until they can increase no more. At that moment they are a candidate for a ventilator. Maybe they "relaxed" the criteria after a while if ventilators showed bad outcomes but when people are maxed out on O2, there is little you can do.

by corin_ 6y ago

war1025 6y ago

I don't have any sources at hand, but the explanation I heard is that ventilators are generally used for people who have healthy lung tissue but are unable to breathe properly. Coronavirus weakens the lung tissue, but the ability to breathe (inhale / exhale) is unaffected. Basically the body was forcing people to have shallow breath to preserve the damaged lung tissue and allow it to recover. The ventilator essentially restored their breathing back to full force, which turned people's lungs into soup basically. Makes sense as an explanation to me, but like I said, I don't have any official sources for that.

saberdancer 6y ago
People are not put on ventilators for no reason. They are put because their oxygen level is so level that they will die if it deteriorates. People ended up on ventilators after they received maximum possible level of supplementary oxygen. This explanation sounds very implausible and simplistic. When a person has extremely low oxygen level and you are giving them maximum oxygen possible, what can you do? Ventilator or ECMO (which is probably even more dangerous).
- war1025 6y ago
  This [1] seems to be a fairly representative article of the sort of thing I've seen. Not peer reviewed, but it hardly seems like fringe lunacy. [1] https://elemental.medium.com/how-one-covid-19-doctor-became-a-ventilator-whistleblower-a1c2dbdd1b06 https://elemental.medium.com/how-one-covid-19-doctor-became-...
  - tptacek 6y ago
    Can you provide a source that wasn't written by a (checks notes) magician?
    - war1025 6y ago
      I don't particularly care about the topic, so no.
- martinald 6y ago
  Not an expert, but as far as I understand with COVID people were not in major distress breathing even with very poor O sats, which is confusing. The standard was to move people with terrible O2 sats at the start of the outbreak to ventilation immedatley, even if they did not seem to bad. That seems to be replaced with providing high levels of O2/CPAP and only moving people to ventilation when that is not sufficient, even if O2 sats would normally indicate ventilation. This is why vent usage is a lot lower this second time round, even with more patients in hopsital.
  - saberdancer 6y ago
    I am not an expert either. I would be surprised if they put someone on a ventilator just because his O2 level was low without first putting him on O2 and maxing out the flow. Little experience that I do have is that people are first put on O2, then if their saturation remains low they increase the flow until they can increase no more. At that moment they are a candidate for a ventilator. Maybe they "relaxed" the criteria after a while if ventilators showed bad outcomes but when people are maxed out on O2, there is little you can do.