This OP comment is incorrect. I have had multiple patients with COVID pneumonia wean from the vent. Some die, some recover. Every one of them were becoming severely hypoxia on oxygen without the vent.
"while not fully understood, it is suspected to bind to DNA and interfere with the ability to work magic on hemoglobin. The same mechanism that stops malaria from getting its hands on hemoglobin and gobbling it up seems to do the same to COVID-19 (essentially little snippets of DNA in an envelope) from binding to it."
There's evidence now that the ventilator is actually what's killing them, as we've been misunderstanding how the virus works.
We thought that the virus causes ARDS, and makes it to where the lungs no longer function properly. This actually doesn't seem to be the case, and it looks more as if the virus is starving the cells of oxygen, thus causing the shortness of breath.
Putting someone on a ventilator while their lungs are still healty/functional is... not a good thing to do, to say the least, and can actually cause their lungs to start failing.
Docs are desperately trying to not put these patients on ventilators.
The only cause to put someone on the vent is if they are imminently about to die from hypoxia.
Some of those die and some do recover.
The virus preferentially infects type II pneumocytes and kills them. This is because this type of cell has more ACE2 expression on the surface. They type II pneumocytes produce surfactant that lowers the surface tension of the lining of the alveoli and prevents their collapse. In addition to underproduction of surfactant, the inflammatory reaction caused by the virus causes increased capillary permeability and further degrades the surfactant, which is especially sensitive to oxidization.
This results in hazy densities in the lungs which progress to overt consolidation, with reduced lung compliance. The reduced compliance predisposes the lungs to mechanical injury caused by ventilators at the high positive end expiratory pressure (PEEP) needed to ventilate these patients.
If you can get by without the vent just with O2 supplemental then I strongly recommend it. The vent is a last resort.
There has been no distinction between death from the virus and death by Ventilator Associated Pneumonia.
https://www.cdc.gov/hai/vap/vap.html
This OP comment is incorrect. I have had multiple patients with COVID pneumonia wean from the vent. Some die, some recover. Every one of them were becoming severely hypoxia on oxygen without the vent.
That's good to know, thanks.
This article is great.
I think there's a typo:
"while not fully understood, it is suspected to bind to DNA and interfere with the ability to work magic on hemoglobin. The same mechanism that stops malaria from getting its hands on hemoglobin and gobbling it up seems to do the same to COVID-19 (essentially little snippets of DNA in an envelope) from binding to it."
I assume he means RNA.
Came in here to say that
There's evidence now that the ventilator is actually what's killing them, as we've been misunderstanding how the virus works.
We thought that the virus causes ARDS, and makes it to where the lungs no longer function properly. This actually doesn't seem to be the case, and it looks more as if the virus is starving the cells of oxygen, thus causing the shortness of breath.
Putting someone on a ventilator while their lungs are still healty/functional is... not a good thing to do, to say the least, and can actually cause their lungs to start failing.
The lungs of people with COVID pneumonia are not healthy. In fact one could say it is the organ most severely unhealthy in COVID pneumonia.
Docs are desperately trying to not put these patients on ventilators.
The only cause to put someone on the vent is if they are imminently about to die from hypoxia.
Some of those die and some do recover.
The virus preferentially infects type II pneumocytes and kills them. This is because this type of cell has more ACE2 expression on the surface. They type II pneumocytes produce surfactant that lowers the surface tension of the lining of the alveoli and prevents their collapse. In addition to underproduction of surfactant, the inflammatory reaction caused by the virus causes increased capillary permeability and further degrades the surfactant, which is especially sensitive to oxidization.
This results in hazy densities in the lungs which progress to overt consolidation, with reduced lung compliance. The reduced compliance predisposes the lungs to mechanical injury caused by ventilators at the high positive end expiratory pressure (PEEP) needed to ventilate these patients.
If you can get by without the vent just with O2 supplemental then I strongly recommend it. The vent is a last resort.