Yea this is objectively bad writing

Kind of, yea. The point is to generate viracidal free radicals. Instead we use inhaled nitric oxide which is a free radical.

Haha love this

Nah, not until they’re humiliated.

Will you cut the malarkey. Look, bud. We’re in - and here’s the deal.

Well, the virus causes a multifocal organizing pneumonia that reduces available airspace for gas exchange causing hypoxic respiratory failure. You need a lot more area for oxygen diffusion than for carbon dioxide. I'm all for exploring alternative hypotheses for disease drivers to explain symptom timeline, but I'm just not seeing the supportive data.

Some heme poison causing reduced oxygen binding precipitating a high-altitude pulmonary edema (HAPE) like syndrome? Ok, let's walk through that. At high enough altitude the globally low alveolar partial pressure of oxygen triggers the pulmonary hypoxic vasoconstriction reflex increasing PA pressures enough to leak fluid through capillary beds. That reflex reflects the low oxygen tension in the lungs, not low oxygen in the blood. So low blood oxygen from a heme binder would not cause the same syndrome. Further, radiologists aren't seeing pulmonary edema, they're seeing diffuse opacifications that evolve into ARDS. We'd see a bunch of right heart failure that accompanies sudden upswings in PA pressures. We'd see many more young adults affected. People with inherited porphyrias would be hugely decompensating. These are my suggestions, they could be wrong but I'm trying to think through the proposal.

I've watched the twitter videos of ED providers making emotional appeals to rethinking this, but they're not giving an explanation and are challenging current thinking without adequately challenging their proposed alternatives. The hypoxia we are seeing is not an oxygen carrying capacity issue (in fact lower hemoglobin seems to be a protective signal), it is an alveolar oxygen supply issue because the virus is attached to lung cell ACE-2 receptors causing them to become virus factories, exploding, causing severe inflammation that goes into ARDS (cellular dissociation and fluid accumulation) requiring high partial pressures of oxygen to overcome and high post expiratory pressures just to keep the alveoli open.

I would not be surprised by some hematologic off-shoot of the virus, I just need to see someone walk me through their thinking beyond making a conspiracy out of it.

I don't mean to rant. I'm an anesthesiologist treating these people. I personally think the reaction is overplayed and fucking love Trump.

This is why I love this man.

Yea PEEP is titrated to compliance and helps with oxygenation.

I appreciate the thought, but all you have to do is look at the chest films of people coming in. It's multifocal pneumonia with completely opacified airspaces. That's not how carbon monoxide poisoning looks or altitude sickness.

Seriously, he's the only person whose opening monologues I never miss.

Wow crazy.

Please add a layer of better phone interactions like swipe actions. It’s so easy to implement and would greatly improve navigation on phones in lieu of an app.

FUCK Reddit. Messages for upvoting the wrong opinions? Unbelievable. Their hateful activism is so transparent.

Would love to have swipe actions for phones though, not a fan of clicking small boxes again. Simple enough to code and would do it for myself but I’m not sure if there is a way to run custom scripts on phone browsers.

Well put.

Those traditions should be kept alive as part of our cultural heritage

Holy shit this is awesome

All the left talks and thinks about is race. It’s so tiresome and frustrating. They posture as “advocates” but are just straight up racists who stable people by race as political cattle that they can round up by scaring them about the big white wolf. It’s sad.

Seriously, just get this shit over with.

FUCK YES. Thanks for all your hard work fellas

hell yea pedes! glad for the new community, may your memes fly as high as your dreams