6 ms·

Jokes aside, when would this be useful? I can't think of many situations where a patient wouldn't be able to breathe but was still alive. Some burn victims I gu

Jokes aside, when would this be useful? I can't think of many situations where a patient wouldn't be able to breathe but was still alive. Some burn victims I guess?

jxf 5y ago
Severe lung obstruction, cases where intubation and tracheotomy are contraindicated, et cetera. It's not super common in the grand scheme of things, but then, neither are tracheotomies.
nigerian1981 5y ago
A previous HN article links to a paper which mentions this would be useful when there is a shortage of ventilators: https://www.cell.com/med/fulltext/S2666-6340(21)00153-7 https://www.cell.com/med/fulltext/S2666-6340(21)00153-7
kragen 5y ago
Maybe some kind of worldwide pandemic of a respiratory infection with a significant fatality rate?
- TheAdamAndChe 5y ago
  Especially if ventilator capacity becomes saturated, this could possibly one day be a scalable alternative.
  - creshal 5y ago
    *Fuck* ventilators. They damage the patient's lungs, and laying tubes into the trachea requires traumatic surgery and carries significant secondary infection risk. ECMO – for patients with too destroyed lungs – is even worse, massive infection risk due to exposing vital arteries and veins, and it destroys your blood cells, requiring constant topping up with fresh blood transfusions. This has the potential to be less invasive than either measure and could give the patients a chance to let their lungs actually heal from all the damage.
    - mikecsh 5y ago
      What a bizarre comment. Every patient who goes under general anaesthesia for surgery (life saving or otherwise) is ventilated and usually without issue. “Laying tubes into the trachea” I presume refers to tracheostomy. Let’s be realistic here - if you are requiring a tracheostomy and ventilator, or ECMO the you are severely unwell. A blood transfusion, or small risk of infection is the least of your worries at that point. As with everything in medicine there is a risk:benefit ratio. If you need ECMO you literally cannot oxygenate your own blood even with a ventilator. No ECMO = you die.
      - creshal 5y ago
        > Let’s be realistic here - if you are requiring a tracheostomy and ventilator, or ECMO the you are severely unwell. Obviously. So why use these invasive procedures if a less invasive one could do the job with less risk? > A blood transfusion, or small risk of infection is the least of your worries at that point. Did you come straight from the 19th century or something? Hospital acquired infections kill hundreds of thousands of people every year. That's hardly a small worry. > As with everything in medicine there is a risk:benefit ratio. No shit. That's why there's interest in alternative procedures with less risk for the same benefit. > If you need ECMO you literally cannot oxygenate your own blood even with a ventilator. Unless… there's a new method that bypasses the lungs. Did you read the linked article?
        mikecsh 5y ago
        Angry much? Calm yourself down. Clearly if anal oxygen proves to be safer and as effective then it will be adopted. No one is disputing that. My comment was regarding your expletive laden derision of devices which save hundreds of thousands of lives. And you seem to have missed the point. I did. It say hospital acquired infections are not prevalent or problematic. My point was that every decision in medicine s based on risk and benefit. If you need ECMO you will almost certainly die without it. If you have ECMO there is a compratively small risk of infection that may kill you. And yes thanks, I did read the article. I’m also a doctor and have spent many months working in ITU, anaesthesia, and operating theatres, and managing acutely unwell COVID-19 patients. Let us all be glad you’re not making any treatment decisions.
- imwillofficial 5y ago
  Define “significant”
  - quickthrower2 5y ago
    So bad that most countries voluntarily fucked up their economy by closing international transport or even interstate or between cities, closed all bars, restaurants and even stop people visiting their families, to prevent it spreading
  - Der_Einzige 5y ago
    P value less than 0.05
    - Engineering-MD 5y ago
      That is statistical significance. There is also clinical significance, ie is it actually worth doing.
- abrookewood 5y ago
  Ahh ... OK, I wasn't thinking clearly. I forgot about the lack of ventilators and was only thinking of the lack of oxygen recently reported in the news.
Symmetry 5y ago
They mention it being less traumatic than intubation so severe Covid-19 that can't be handled with just an oxygen mask would be one reason to administer this.

Jokes aside, when would this be useful? I can't think of many situations where a patient wouldn't be able to breathe but was still alive. Some burn victims I guess?

jxf 5y ago

Severe lung obstruction, cases where intubation and tracheotomy are contraindicated, et cetera. It's not super common in the grand scheme of things, but then, neither are tracheotomies.

nigerian1981 5y ago

A previous HN article links to a paper which mentions this would be useful when there is a shortage of ventilators: https://www.cell.com/med/fulltext/S2666-6340(21)00153-7 https://www.cell.com/med/fulltext/S2666-6340(21)00153-7

kragen 5y ago

Maybe some kind of worldwide pandemic of a respiratory infection with a significant fatality rate?

TheAdamAndChe 5y ago
Especially if ventilator capacity becomes saturated, this could possibly one day be a scalable alternative.
- creshal 5y ago
  *Fuck* ventilators. They damage the patient's lungs, and laying tubes into the trachea requires traumatic surgery and carries significant secondary infection risk. ECMO – for patients with too destroyed lungs – is even worse, massive infection risk due to exposing vital arteries and veins, and it destroys your blood cells, requiring constant topping up with fresh blood transfusions. This has the potential to be less invasive than either measure and could give the patients a chance to let their lungs actually heal from all the damage.
  - mikecsh 5y ago
    What a bizarre comment. Every patient who goes under general anaesthesia for surgery (life saving or otherwise) is ventilated and usually without issue. “Laying tubes into the trachea” I presume refers to tracheostomy. Let’s be realistic here - if you are requiring a tracheostomy and ventilator, or ECMO the you are severely unwell. A blood transfusion, or small risk of infection is the least of your worries at that point. As with everything in medicine there is a risk:benefit ratio. If you need ECMO you literally cannot oxygenate your own blood even with a ventilator. No ECMO = you die.
    - creshal 5y ago
      > Let’s be realistic here - if you are requiring a tracheostomy and ventilator, or ECMO the you are severely unwell. Obviously. So why use these invasive procedures if a less invasive one could do the job with less risk? > A blood transfusion, or small risk of infection is the least of your worries at that point. Did you come straight from the 19th century or something? Hospital acquired infections kill hundreds of thousands of people every year. That's hardly a small worry. > As with everything in medicine there is a risk:benefit ratio. No shit. That's why there's interest in alternative procedures with less risk for the same benefit. > If you need ECMO you literally cannot oxygenate your own blood even with a ventilator. Unless… there's a new method that bypasses the lungs. Did you read the linked article?
      - mikecsh 5y ago
        Angry much? Calm yourself down. Clearly if anal oxygen proves to be safer and as effective then it will be adopted. No one is disputing that. My comment was regarding your expletive laden derision of devices which save hundreds of thousands of lives. And you seem to have missed the point. I did. It say hospital acquired infections are not prevalent or problematic. My point was that every decision in medicine s based on risk and benefit. If you need ECMO you will almost certainly die without it. If you have ECMO there is a compratively small risk of infection that may kill you. And yes thanks, I did read the article. I’m also a doctor and have spent many months working in ITU, anaesthesia, and operating theatres, and managing acutely unwell COVID-19 patients. Let us all be glad you’re not making any treatment decisions.
imwillofficial 5y ago
Define “significant”
- quickthrower2 5y ago
  So bad that most countries voluntarily fucked up their economy by closing international transport or even interstate or between cities, closed all bars, restaurants and even stop people visiting their families, to prevent it spreading
- Der_Einzige 5y ago
  P value less than 0.05
  - Engineering-MD 5y ago
    That is statistical significance. There is also clinical significance, ie is it actually worth doing.
abrookewood 5y ago
Ahh ... OK, I wasn't thinking clearly. I forgot about the lack of ventilators and was only thinking of the lack of oxygen recently reported in the news.

Symmetry 5y ago

They mention it being less traumatic than intubation so severe Covid-19 that can't be handled with just an oxygen mask would be one reason to administer this.