Sign in to follow this  
mikewof

Staggering finding regarding deaths from SARS-CoV-2.

Recommended Posts

https://jamanetwork.com/journals/jama/fullarticle/2765302

and thus: https://www.medscape.com/viewarticle/928156

Or maybe it's just staggering to me, because it reinforces the idea that a virus should normally not cause that kind of mayhem. It also suggests a sensitivity for patients with a loss of lung elasticity. If this team is proven correct, they should be considered for the Nobel Prize.

Share this post


Link to post
Share on other sites

Coronavirus can and does kill young people - and many have one thing in common

Ismail Mohamed Abdulwahab, 13, died alone in a London hospital, his lungs drowning in the fluid caused by coronavirus.

Sixteen-year-old Julie became France’s youngest COVID-19 fatality.

Luca Di Nicola, 19, was described as “fit and healthy”.

 

He was taken by ambulance to the North Middlesex Hospital in England suffering from coronavirus and died 30 minutes after he arrived.

Share this post


Link to post
Share on other sites

Fucking staggering.  Mikey saying that it's not the virus killing people.  It's all these other things ... whatever they are.

Zero % mortality rate!!!!   See Trump did the right thing!!!!   It's only the medical cretins responsible for any deaths!!!!!

63b68741174c33c3de9223e41e8fcabefaf1a94d

tenor.gif

Share this post


Link to post
Share on other sites

Doctors Link COVID-19 To Potentially Deadly Blood Clots And Strokes

When COVID-19 patients began flooding emergency departments at New York hospitals in March, doctors saw some unusual cases of stroke.

"We had a young woman in her early 30s who came in with a profound stroke, the kind of stroke that leaves someone permanently paralyzed and possibly unable to survive," says Dr. J. Mocco, a professor of neurosurgery and director of the cerebrovascular center at Mount Sinai Health System in New York.

Her stroke was caused by a blood clot that was restricting blood flow to the right side of her brain. The young woman had none of the usual risk factors for stroke. But she tested positive for SARS-CoV-2, the coronavirus that causes COVID -19.

And so did several other young, otherwise healthy people who had been admitted for major strokes. So Mocco and other doctors in the hospital system began to compare notes.

Share this post


Link to post
Share on other sites

At the risk of agreeing with Mikey, and interrupting the dog pile....

Ventilator management changed about 20 years ago when they changed from  "crank it up and get the CO2 down"  to 'permissive hypercapnia' and 'lung protection'

Our study increased survivability in ARDS from 20% to 30% just by ventilator settings while simultaneously killing liquid ventilation (and my job). 

Interesting to see that this disease flips the script. Lots of O2, Vt and keep PEEP down. 

These are the kinds of things that takes time for the medical field to figure out. 

 

 

  • Like 1

Share this post


Link to post
Share on other sites

Damn, Mikey just discovered the virus kills people. Way to go Mikey!

Share this post


Link to post
Share on other sites
53 minutes ago, Kirwan said:

At the risk of agreeing with Mikey, and interrupting the dog pile....

Ventilator management changed about 20 years ago when they changed from  "crank it up and get the CO2 down"  to 'permissive hypercapnia' and 'lung protection'

Our study increased survivability in ARDS from 20% to 30% just by ventilator settings while simultaneously killing liquid ventilation (and my job). 

Interesting to see that this disease flips the script. Lots of O2, Vt and keep PEEP down. 

These are the kinds of things that takes time for the medical field to figure out. 

It also seems to "flip the script" in compliance versus elastance. In a sense, it's like a new disease. 

Just changing the protocols changed the mortality from over 60% to 0%!

As you write, it normally takes years to figure these things out, but they found this one in just months. If this means what it seems to mean, it's Nobel Prize worthy.

Share this post


Link to post
Share on other sites
18 minutes ago, Raz'r said:

Damn, Mikey just discovered the virus kills people. Way to go Mikey!

Did you read the paper? You should read it. There might be a little of the old Raz'r still in you.

Share this post


Link to post
Share on other sites
Just now, mikewof said:

Did you read the paper? It seems to be the old protocol that's killing people.

Uh, no. Not everyone gets a vent. Why are fighting the facts on this one? Science is supposed to be facts/hypothesis/facts, hypotheses, etc

youre all “I got my hypothesis, let me find a fact, there’s gotta be a fact around here somewhere, if I just bullshit enough”

  • Like 1

Share this post


Link to post
Share on other sites
2 minutes ago, Raz'r said:

Uh, no. Not everyone gets a vent. Why are fighting the facts on this one? Science is supposed to be facts/hypothesis/facts, hypotheses, etc

youre all “I got my hypothesis, let me find a fact, there’s gotta be a fact around here somewhere, if I just bullshit enough”

Right, not everyone gets a vent, what's the mortality of those on a ventilator versus those who are not?

Share this post


Link to post
Share on other sites
1 minute ago, Raz'r said:
4 minutes ago, mikewof said:

Did you read the paper? It seems to be the old protocol that's killing people.

Uh, no. Not everyone gets a vent. Why are fighting the facts on this one? Science is supposed to be facts/hypothesis/facts, hypotheses, etc

youre all “I got my hypothesis, let me find a fact, there’s gotta be a fact around here somewhere, if I just bullshit enough”

Sure

Everyone knows doctors are actually sitting around in the hospital saying "eenie-meenie minie moe, who get's hooked up to a ventilator this morning?"

Virus does not kill cells! Virus are actually our friends!

- DSK

 

Share this post


Link to post
Share on other sites
Just now, mikewof said:

Right, not everyone gets a vent, what's the mortality of those on a ventilator versus those who are not?

 

Depends on whether they can breathe on their own, doesn't it?

- DSK

Share this post


Link to post
Share on other sites
1 minute ago, Steam Flyer said:

Sure

Everyone knows doctors are actually sitting around in the hospital saying "eenie-meenie minie moe, who get's hooked up to a ventilator this morning?"

Virus does not kill cells! Virus are actually our friends!

- DSK

 

Did you read the paper?

Share this post


Link to post
Share on other sites
Just now, Steam Flyer said:

 

Depends on whether they can breathe on their own, doesn't it?

- DSK

And their saturation.

Share this post


Link to post
Share on other sites
11 minutes ago, mikewof said:

it's Nobel Prize worthy.

Ahem,  it's Noble Prize.  And if anyone wins it, they should give it back.  Many people are saying it.  Believe me.

  • Like 1

Share this post


Link to post
Share on other sites
1 minute ago, Swimsailor said:

Ahem,  it's Noble Prize.  And if anyone wins it, they should give it back.  Many people are saying it.  Believe me.

Excellent!

Share this post


Link to post
Share on other sites
2 minutes ago, mikewof said:

Did you read the paper?

I've been privileged to read field notes from doctors who are in major metro hospitals working on this stuff.

You may recall about two weeks ago I mentioned clotting as problem

- DSK

Share this post


Link to post
Share on other sites
20 minutes ago, mikewof said:

Did you read the paper? You should read it. There might be a little of the old Raz'r still in you.

Do you read the papers that others suggest to you ? No, you do not. And you say so openly. 

So why on earth should we read yours ? 

Share this post


Link to post
Share on other sites
12 minutes ago, Steam Flyer said:

I've been privileged to read field notes from doctors who are in major metro hospitals working on this stuff.

You may recall about two weeks ago I mentioned clotting as problem

- DSK

Then you're fortunate that you've seen this from the beginning. Something to tell your great grandchildren.

If you have the time to listen to the entire Kyle-Siddell interview or read the transcript, you'll be even more astonished.

The transcript fixed a small but critical mis-speak from Dr. Kyle-Siddell.

For some reason, the link yesterday opened to the video, but today it's the transcript. It might also be because I just joined Medscape yesterday.

Share this post


Link to post
Share on other sites
6 minutes ago, AJ Oliver said:

Do you read the papers that others suggest to you ? No, you do not. And you say so openly. 

So why on earth should we read yours ? 

Jeez professor, get a grip. The twentieth article about postal banking written by a NYT journalist is not even in the same league as this.

Share this post


Link to post
Share on other sites
20 minutes ago, mikewof said:

Jeez professor, get a grip. The twentieth article about postal banking written by a NYT journalist is not even in the same league as this.

Mikeys papers are the best.  Everyone is saying it. Belief me.

  • Like 1

Share this post


Link to post
Share on other sites
45 minutes ago, mikewof said:

It also seems to "flip the script" in compliance versus elastance. In a sense, it's like a new disease. 

Just changing the protocols changed the mortality from over 60% to 0%!

As you write, it normally takes years to figure these things out, but they found this one in just months. If this means what it seems to mean, it's Nobel Prize worthy.

I suppose if you're watching dozens die daily on standard protocols, you start questioning them and trying something different.  

Not sure what everyone's bug about Mikey is, and while I'm no medico, I know a bit about this field, and these findings are very promising; change the knobs and save lives; what's not to like? 

 

Share this post


Link to post
Share on other sites
2 minutes ago, Kirwan said:

I suppose if you're watching dozens die daily on standard protocols, you start questioning them and trying something different.  

Not sure what everyone's bug about Mikey is, and while I'm no medico, I know a bit about this field, and these findings are very promising; change the knobs and save lives; what's not to like? 

 

My friend is a medical aggregator, she came across some results from Germany where they used these new protocols on some overflow patients from France, six critically ill patients, they saved all six.

Perhaps the reason Germany has so few deaths from this is because of those protocols? The idea of a disease flipping from high compliance to low compliance like that is so freaking weird. I see that with my rubber ozone test strips, they get a lot of surface damage from the ozone interaction, with high compliance, but as soon as they are "inflated" there is interfacial damage and they suddenly become low compliance. I had to add an entirely new measurement because the before versus after the inflation was so nonlinear.

You mentioned that your updated protocols changed the ARDS survivability, why did they no longer need your liquid ventilation after that?

Share this post


Link to post
Share on other sites
1 hour ago, mikewof said:

Right, not everyone gets a vent, what's the mortality of those on a ventilator versus those who are not?

It's your hypothesis, you do the work.

Share this post


Link to post
Share on other sites

This isn’t breaking news. Such compliance variance has been known since #s of patients in NYC started climbing.

As the authors state, this disease spans a continuum along lung compliance curves, from low elastance/high compliance to high elastance/low compliance that is essentially ARDS, requiring low volume/high PEEP bent settings. The high compliance pts are characterized by having low O2 sats but not perceiving it, and their lung density on CT scans appear lower than the ARDS-like group.

This ain’t prize worthy stuff, just tailoring vent strategies to clinical manifestations of dz in groups of patients.

Share this post


Link to post
Share on other sites
1 minute ago, phillysailor said:

This isn’t breaking news. Such compliance variance has been known since #s of patients in NYC started climbing.

As the authors state, this disease spans a continuum along lung compliance curves, from low elastance/high compliance to high elastance/low compliance that is essentially ARDS, requiring low volume/high PEEP bent settings. The high compliance pts are characterized by having low O2 sats but not perceiving it, and their lung density on CT scans appear lower than the ARDS-like group.

This ain’t prize worthy stuff, just tailoring vent strategies to clinical manifestations of dz in groups of patients.

Ahh, but you miss Mikey's real point. It's not the virus that's killing patients, it's the Treatment!

It's clear that an intervention is necessary. 

Share this post


Link to post
Share on other sites
22 minutes ago, Kirwan said:

I suppose if you're watching dozens die daily on standard protocols, you start questioning them and trying something different.  

Not sure what everyone's bug about Mikey is, and while I'm no medico, I know a bit about this field, and these findings are very promising; change the knobs and save lives; what's not to like? 

 

Your funeral :)

 

 

 

 

 

edit.. as in, you will come to regret engaging with Mike on this topic.

Share this post


Link to post
Share on other sites
54 minutes ago, AJ Oliver said:

Do you read the papers that others suggest to you ? No, you do not. And you say so openly. 

So why on earth should we read yours ? 

Medscape is a great resource, not sure if you can get much access but even the headlines tell a lot. It's certainly not Mikey's paper

 

3 minutes ago, phillysailor said:

This isn’t breaking news. Such compliance variance has been known since #s of patients in NYC started climbing.

As the authors state, this disease spans a continuum along lung compliance curves, from low elastance/high compliance to high elastance/low compliance that is essentially ARDS, requiring low volume/high PEEP bent settings. The high compliance pts are characterized by having low O2 sats but not perceiving it, and their lung density on CT scans appear lower than the ARDS-like group.

This ain’t prize worthy stuff, just tailoring vent strategies to clinical manifestations of dz in groups of patients.

Yep, all part of what I was trying to explain weeks ago when the subject of sharing ventilators and home-brew-ing ventilators was all the rage. And my knowledge of the topic is not on a professional level, not at all. Thanks for filling in the blanks PS

- DSK

Share this post


Link to post
Share on other sites
25 minutes ago, Kirwan said:

I suppose if you're watching dozens die daily on standard protocols, you start questioning them and trying something different.  

Not sure what everyone's bug about Mikey is, and while I'm no medico, I know a bit about this field, and these findings are very promising; change the knobs and save lives; what's not to like? 

 

Changing the Head Knob would save many lives.

3fy7nc.jpg

Share this post


Link to post
Share on other sites
10 minutes ago, phillysailor said:

This isn’t breaking news. Such compliance variance has been known since #s of patients in NYC started climbing.

As the authors state, this disease spans a continuum along lung compliance curves, from low elastance/high compliance to high elastance/low compliance that is essentially ARDS, requiring low volume/high PEEP bent settings. The high compliance pts are characterized by having low O2 sats but not perceiving it, and their lung density on CT scans appear lower than the ARDS-like group.

This ain’t prize worthy stuff, just tailoring vent strategies to clinical manifestations of dz in groups of patients.

There is something new here though, that flip from high compliance to low compliance. It seems to happen in a shot. This isn't just tailoring, it's a new approach. If the results from Germany are an indicator, it absolutely is prize-worthy.

Share this post


Link to post
Share on other sites
8 minutes ago, Steam Flyer said:

Medscape is a great resource, not sure if you can get much access but even the headlines tell a lot. It's certainly not Mikey's paper.

 

I was able to see the whole video interview yesterday before I got Medscape access, today it's the transcript too. Obviously it's not my paper, it's just that the usual crew here can be a bit averse to "reading" ...

Here's the salient bit from Dr. Kyle-Sidell ...

Kyle-Sidell: First, I'll describe what Gattinoni was saying, which is that really what we're seeing in ARDS are two different phenotypes: one in which the lungs display what you call high compliance, low elastance; and one in which they have low compliance and high elastance. To say it simply for people who are not pulmonologists, if you think of the lungs as a balloon, typically when people have ARDS or pneumonia, the balloon gets thicker. So not only do you lack oxygen, but the pressure and the work to blow up the balloon becomes greater. So one's respiratory muscles become tired as they struggle to breathe. And patients need pressure. What Gattinoni is saying is that there are essentially two different phenotypes, one in which the balloon is thicker, which is a low-compliance disease. But in the beginning they display high compliance. Imagine if the balloon is not actually thicker but thinner, so they'd suffer from a lack of oxygen. But it is not that they suffer from too much work to blow up the balloon. As far as how we're going to switch, we're going to take our approach differently from the traditional ARDSnet protocol in that we are going to do an oxygen-first strategy: We're going to leave the oxygen levels as high as possible and we're going to try to use the lowest pressures possible to try to keep the oxygen levels high. That's the approach we're going to do, so long as the patients continue to display the physiology of a low elastance, high-compliance disease.

Share this post


Link to post
Share on other sites
29 minutes ago, mikewof said:

 ...is so freaking I see that with my rubber ozone test strips, they get a lot of surface damage from the ozone interaction, with high compliance, but as soon as they are "inflated" there is interfacial damage and they suddenly become low compliance. ...

Pure mikey! The only reason I read his vomits of techno babble is to find these tangential gems.

I can translate the above: Rubber bands get old and no longer work well. Grandma knew this.

Trapped in a room with @mikewof would be a worse death than the virus. I’ve had some narrow escapes in my lifetime.

Share this post


Link to post
Share on other sites
1 hour ago, mikewof said:

Jeez professor, get a grip. The twentieth article about postal banking written by a NYT journalist is not even in the same league as this.

Who among us is without grip? 

What twenty? Got a cite? Did not think so. 

And the article I recommended was not written by a NYT journalist, but rather a US senator. 

In your arrogance, you repeatedly get basic facts wrong. 

You are a waste of time. 

For the rest of ya, here it is again . . clear, concise - not like Mikey at all 

(sorry for my part in the thread drift) 

https://www.nytimes.com/2020/04/26/opinion/kirsten-gillibrand-usps-coronavirus.html

Share this post


Link to post
Share on other sites

Obviously, the guys a right-wing nut sack.  

 I'm going to continue following Dr. Fauci's and Bill Gates suggestions which are based in science. Fauci has even funded the research with the backing of NIAID, the National Institutes of Health committed $3.7 million over six years for research that included some gain-of-function work. The program followed another $3.7 million, 5-year project for collecting and studying bat coronaviruses, which ended in 2019, bringing the total to $7.4 million.

Google should remove this video as it is dangerous and misleading.  :angry:

Share this post


Link to post
Share on other sites
1 hour ago, El Boracho said:

Pure mikey! The only reason I read his vomits of techno babble is to find these tangential gems.

I can translate the above: Rubber bands get old and no longer work well. Grandma knew this.

Trapped in a room with @mikewof would be a worse death than the virus. I’ve had some narrow escapes in my lifetime.

And there you go, you have "simplified" it to the point where it is now meaningless and wrong.

The point of those researchers is that these damaged "rubber bands" aren't like the lungs they've seen before, because one moment they think they have a thick balloon, and the next moment it's a thin one. It's a nonlinear response.

 

Share this post


Link to post
Share on other sites
51 minutes ago, Venom said:

Obviously, the guys a right-wing nut sack.  

 I'm going to continue following Dr. Fauci's and Bill Gates suggestions which are based in science. Fauci has even funded the research with the backing of NIAID, the National Institutes of Health committed $3.7 million over six years for research that included some gain-of-function work. The program followed another $3.7 million, 5-year project for collecting and studying bat coronaviruses, which ended in 2019, bringing the total to $7.4 million.

Google should remove this video as it is dangerous and misleading.  :angry:

The "right wing nut sack" is in fact an emergency room doctor in NYC, and he's following a protocol that seems to work very well in Germany.

The video that you want Google to remove may save lives. 

Share this post


Link to post
Share on other sites
1 minute ago, mikewof said:

The "right wing nut sack" is in fact an emergency room doctor in NYC, and he's following a protocol that seems to work very well in Germany.

The video that you want Google to remove may save lives. 

So Mikey, you seem to be off the co-infection kick.Yeah?

Share this post


Link to post
Share on other sites
2 hours ago, Kirwan said:

I suppose if you're watching dozens die daily on standard protocols, you start questioning them and trying something different.  

Not sure what everyone's bug about Mikey is, and while I'm no medico, I know a bit about this field, and these findings are very promising; change the knobs and save lives; what's not to like? 

 

You are simply seeing the results of idiots who think personal attack is an effective argument.  Middle School kiddie shit.

Clinicians will try things that worked on similar symptoms and watch results.

It may well be that a drug taken before a person becomes symptomatic is ineffective once the symptoms appear.

Human responses remain a mystery and SARS-CoV-2 wasn't know to exist in Early December let alone that it was causing an unusual Pneumonia.

With COVID inflammation and COVID toes, this disease is beginning to look like a collection of symptoms driven by an effect on the immune system.  Pretty much like AIDS.

Shit, any medical soap opera could have had this solved in an hour.  Two if they needed a cliffhanger to lead to next week.

Share this post


Link to post
Share on other sites
41 minutes ago, Raz'r said:

So Mikey, you seem to be off the co-infection kick.Yeah?

The coinfection link was confirmed for many cases already, as far back as the last SARS outbreak'in 2004.

This is new, it seems to have less to do with a contagion than a condition they haven't seen before. When have you heard of lungs popping from low to high compliance like that? It's almost like something snaps. And it fits the tales from the ER that these patients with 70% saturation or less are fully aware, they get them on the ventilator and they die nearly without warning.

I haven't seen anything to explain why that happens, I've never heard of a contagion doing that, but it doesn't matter, because they now have a way to manage it ... low pressure, high oxygen. This likely would have never happened in the era of oxygen tents, because they just used low constant pressure. And it might explain the low mortality with non-invasive respiration.

My sister told me just this morning that NYC hospitals are already avoiding intubation, using old fashioned oxygen in the nose, Keppel, and tilting the beds. 

Share this post


Link to post
Share on other sites
44 minutes ago, Saorsa said:

You are simply seeing the results of idiots who think personal attack is an effective argument.  Middle School kiddie shit.

Clinicians will try things that worked on similar symptoms and watch results.

It may well be that a drug taken before a person becomes symptomatic is ineffective once the symptoms appear.

Human responses remain a mystery and SARS-CoV-2 wasn't know to exist in Early December let alone that it was causing an unusual Pneumonia.

With COVID inflammation and COVID toes, this disease is beginning to look like a collection of symptoms driven by an effect on the immune system.  Pretty much like AIDS.

Shit, any medical soap opera could have had this solved in an hour.  Two if they needed a cliffhanger to lead to next week.

A lot like AIDS, but there seems to be something mechanical at work here in the lungs. These patients that come in with 70% saturation, fully conversational, is if they had been living at 70% for months or even years, and had adapted to it like Himalayan Sherpas.

Share this post


Link to post
Share on other sites

What appears to be happening, that Mikey is excited about, is how these patients with normal elastance “may” quickly decompensate, with extravasation of fluid and development of acute respiratory  failure due to V/Q mismatch.

V= Ventilation and Q= perfusion. Normally these are in balance, so you send air to parts of lung that are also getting blood supply. If you send air, but no blood supply goes past, (V>>Q) there is no gas exchange from/to hemoglobin in blood despite good ventilation... “dead space”. These parts of lung might as well be a longer trachea, for all the good they do a person. Think of a giraffe which has to pull a few liters of air in just to move the air in that looong windpipe before moving fresh air in/out of the lungs.

This could be caused by a pulmonary embolism, which blocks blood supply through a portion of lung that’s being ventilated just fine.

If perfusion >> ventilation there are parts of lung getting blood rushing past alveoli (the functional subunit of lung) that have no gas within... perhaps they are collapsed or they are full of fluid. This is called “shunt”, because it’s as if the right heart was shunting blood to the left without going through the lungs.

There are many conditions which can rapidly fill lungs with fluid. Aspiration, flash pulmonary edema, allergic reactions, progressive pneumonia, choking can all cause interstitial fluid to rapidly fill alveoli and cause V/Q mismatch. The body can compensate to an impressive degree, altering local blood supply to restrict flow past non-ventilated segments.

The authors surmise that some feature of this disease prevents this autoregulation, leading to widespread shunt, with concomitant low SaO2, since a percentage of blood entering their left heart never gets oxygenated.

Intubating and sedating, perhaps paralyzing these patients and cautiously ventilating them can prevent harm from high pressures being applied to uninjured lung.
 

When treating ARDS, high PEEP settings (the amount of pressure in the lungs at the end of an exhalation) are typically used in ARDS to “stent” (keep) alveoli open. High peak pressures “SNAP” open those alveoli.

Minimizing these high pressures in early COVID patients may prevent damaging alveoli by not imposing high shear stresses on as-yet undamaged lung (the authors call it “baby lung.”

This is a quick primer on some isolated features of lung physiology and vent strategies, not meant to be comprehensive or fully explanatory. I’m explicitly trying to give the impression that considering these forces, V/Q mismatch and lung pathology is what clinicians do all the time.

Essentially, this isn’t ARDS, until it gets bad. Until it is, using ARDS vent strategies does more harm than good. That’s become clear over the last 6 weeks. 

  • Like 1

Share this post


Link to post
Share on other sites

The way choking causes fluid to enter alveoli is somewhat interesting.

Effortful inspiration against a blocked windpipe creates negative pressures (a vacuum) within the respiratory tree. Fluid is literally sucked from the interstitium (walls) of the lung passages into respiratory passages and alveoli.

Even after relieving the mechanical or physiological obstruction, the patient may not be out of the woods due to the flash pulmonary edema with which they must contend. White or pink frothy sputum & noisy rattles when breathing returns may tell the tale.

Care is supportive: oxygenation, suctioning, diuresis may help. 

For bonus points, what is the V/Q mismatch during such an episode?

Share this post


Link to post
Share on other sites
24 minutes ago, phillysailor said:

The way choking causes fluid to enter alveoli is somewhat interesting.

Effortful inspiration against a blocked windpipe creates negative pressures (a vacuum) within the respiratory tree. Fluid is literally sucked from the interstitium (walls) of the lung passages into respiratory passages and alveoli.

Even after relieving the mechanical or physiological obstruction, the patient may not be out of the woods due to the flash pulmonary edema with which they must contend. White or pink frothy sputum & noisy rattles when breathing returns may tell the tale.

Care is supportive: oxygenation, suctioning, diuresis may help. 

For bonus points, what is the V/Q mismatch during such an episode?

Diffusion limitation ! (?)   much more Q than V

  • Like 1

Share this post


Link to post
Share on other sites

Uh... Mike?  I brought this up ten days ago, when I was trying to get you to look past your co-infection obsession. 

I linked to an article in Time magazine, from two weeks ago.

https://time.com/5820556/ventilators-covid-19/

It's great that you're catching up, but... it's hardly "staggering", at this point, it's more like "old hat".

  • Like 1

Share this post


Link to post
Share on other sites

 

3 hours ago, Venom said:

Obviously, the guys a right-wing nut sack.  

 I'm going to continue following Dr. Fauci's and Bill Gates suggestions which are based in science. Fauci has even funded the research with the backing of NIAID, the National Institutes of Health committed $3.7 million over six years for research that included some gain-of-function work. The program followed another $3.7 million, 5-year project for collecting and studying bat coronaviruses, which ended in 2019, bringing the total to $7.4 million.

Google should remove this video as it is dangerous and misleading.  :angry:

I think you posted in the wrong thread? 

Share this post


Link to post
Share on other sites
22 minutes ago, frenchie said:

Uh... Mike?  I brought this up ten days ago, when I was trying to get you to look past your co-infection obsession. 

I linked to an article in Time magazine, from two weeks ago.

https://time.com/5820556/ventilators-covid-19/

It's great that you're catching up, but... it's hardly "staggering", at this point, it's more like "old hat".

The article was just published yesterday. Can you let me borrow your time machine? I had a hot tip in a horse race that turned out to be dead nuts money, but I never got to use it.

Share this post


Link to post
Share on other sites
1 hour ago, mikewof said:

A lot like AIDS, but there seems to be something mechanical at work here in the lungs. These patients that come in with 70% saturation, fully conversational, is if they had been living at 70% for months or even years, and had adapted to it like Himalayan Sherpas.

they are finding micro clots in lungs now.

This thing isn't whipped and won't be for a long while.

Share this post


Link to post
Share on other sites
30 minutes ago, mikewof said:

The article was just published yesterday. Can you let me borrow your time machine? I had a hot tip in a horse race that turned out to be dead nuts money, but I never got to use it.

The article that integrates this into formal guidance, yeah. 

But did you notice the date on the second link in your OP, the one co-authored by Kile-Sydell?  April 6.  3 weeks ago.  

The video on youtube, where he first brought this up, was posted on March 31  -  a month ago.

Share this post


Link to post
Share on other sites

The coagulopathy is causing Heart-attack like conditions in folks with no atherosclerosis. Multiple PEs, and strokes, organ failure (kidneys, GI tract.)

I think it’s some inflammatory cascade process side effect. 

Colleagues are describing severe body aches limiting movement, and many patients spend several days in bed. If they are smokers or have diabetes, they quickly rack up more reasons for excessive clotting.

Share this post


Link to post
Share on other sites
14 minutes ago, phillysailor said:

The coagulopathy is causing Heart-attack like conditions in folks with no atherosclerosis. Multiple PEs, and strokes, organ failure (kidneys, GI tract.)

I think it’s some inflammatory cascade process side effect. 

Colleagues are describing severe body aches limiting movement, and many patients spend several days in bed. If they are smokers or have diabetes, they quickly rack up more reasons for excessive clotting.

Well, this thing sounds better and better all the time.  (Yes, folks, it's PURPLE.)

Share this post


Link to post
Share on other sites
15 hours ago, mikewof said:

https://jamanetwork.com/journals/jama/fullarticle/2765302

and thus: https://www.medscape.com/viewarticle/928156

Or maybe it's just staggering to me, because it reinforces the idea that a virus should normally not cause that kind of mayhem. It also suggests a sensitivity for patients with a loss of lung elasticity. If this team is proven correct, they should be considered for the Nobel Prize.

What are you trying to say? Plenty of human viruses cause far more grisly “mayhem”. Some are 100% fatal. Some in the most unpleasant way possible. Or maybe you mean some particular kind of mayhem? The many killer viruses seem to have no limit to what types of bodily harm they can do. Short of breaking bones ... wait ... the Dengue Virus effects are colloquially called Break Bone Fever :-)

HIV had been quite staggering in its power. Luckily it is not so casually contagious.

But I have never figured out the point, in PA context, of your posts. So...

Share this post


Link to post
Share on other sites
3 minutes ago, El Boracho said:

But I have never figured out the point, in PA context, of your posts. So...

His point is to sow seeds of doubt about any subject that does not support the Trump administration.

Climate Change?  He says it's not caused by humans.

COVID-19? He says it's caused by everything else except the virus.  And it's not as deadly as the Flu.

He is a right wing troll who most likely does this same shit on other forums.

Share this post


Link to post
Share on other sites
37 minutes ago, frenchie said:

The article that integrates this into formal guidance, yeah. 

But did you notice the date on the second link in your OP, the one co-authored by Kile-Sydell?  April 6.  3 weeks ago.  

The video on youtube, where he first brought this up, was posted on March 31  -  a month ago.

He talked about that in the article. When someone is dying, they'll put him or her on a ventilator, regardless the Time magazine article.

I mentioned some articles about a month ago that preferred noninvasive intubation.

This is something genuinely new. It's specific results from Germany that dropped the mortality from 60% to zero. It's specific protocol that hospitals can use today. And it recognizes the changing elastance. This isn't blase research that is just a recolor of something that everyone already knew.

That we can look back at an old video just shows that they were looking into it, but the doctor himself couldn't use that protocol. Now maybe they can.

Share this post


Link to post
Share on other sites
32 minutes ago, El Boracho said:

What are you trying to say? Plenty of human viruses cause far more grisly “mayhem”. Some are 100% fatal. Some in the most unpleasant way possible. Or maybe you mean some particular kind of mayhem? The many killer viruses seem to have no limit to what types of bodily harm they can do. Short of breaking bones ... wait ... the Dengue Virus effects are colloquially called Break Bone Fever :-)

HIV had been quite staggering in its power. Luckily it is not so casually contagious.

But I have never figured out the point, in PA context, of your posts. So...

It's a coronavirus. It doesn't cause the mayhem you describe about 99.3% of the time.

They get these people on ventilators and 60% of them died, the mayhem begins. Then they use the German protocol and zero of them die. The mayhem ends.

If we had known about this approach earlier, maybe the U.S.death rate would be low like Germany's, so perhaps you can figure out the point now?

Share this post


Link to post
Share on other sites
1 hour ago, Saorsa said:

they are finding micro clots in lungs now.

This thing isn't whipped and won't be for a long while.

The embolism thing isn't new though, it's a not-uncommon result in COPD too. Lungs do that it seems.

I agree with you that it isn't over, we have to lose our cookies over facemasks, and keep businesses and playgrounds dosed as we fight The War on Viruses.

But we now have a protocol that has been shown to essentially eliminate the problem that has possibly killed tens of thousands.

Share this post


Link to post
Share on other sites
43 minutes ago, Raz'r said:

Well, this thing sounds better and better all the time.  (Yes, folks, it's PURPLE.)

Sounds like what most hospitals tell you.  No matter how sick, you're almost always better off getting up and moving around if you can.  Being sedentary is a killer.

Share this post


Link to post
Share on other sites
3 minutes ago, mikewof said:

I agree with you that it isn't over, we have to lose our cookies over facemasks, and keep businesses and playgrounds dosed as we fight The War on Viruses

Pretty pathetic how you continue to minimize.

  • Like 1

Share this post


Link to post
Share on other sites

I’m remaining skeptical of any reports of treatments which proclaim 0 fatalities as a result of their therapy. So far, they haven’t borne scrutiny very well.

YMMV

  • Like 1

Share this post


Link to post
Share on other sites
44 minutes ago, mikewof said:

It's a coronavirus. It doesn't cause the mayhem you describe about 99.3% of the time.

They get these people on ventilators and 60% of them died, the mayhem begins. Then they use the German protocol and zero of them die. The mayhem ends.

If we had known about this approach earlier, maybe the U.S.death rate would be low like Germany's, so perhaps you can figure out the point now?

This is what Mikey is saying:

1. There is no reason for people to die from CONVID-19

2. If they do die then it's the doctors fault

3. Trump is not to blame

source.gif

  • Like 1

Share this post


Link to post
Share on other sites
41 minutes ago, Grrr... said:
1 hour ago, Raz'r said:

Well, this thing sounds better and better all the time.  (Yes, folks, it's PURPLE.)

Sounds like what most hospitals tell you.  No matter how sick, you're almost always better off getting up and moving around if you can.  Being sedentary is a killer.

Well, there ya go.

Instead of hooking up all those patients to ventilators, when they can no longer breath well enough to get oxygen into their blood, just get them up on their feet. Maybe play some MC Hammer tunes?

I'm sure there's an algorithm for that.

- DSK

Share this post


Link to post
Share on other sites
7 hours ago, mikewof said:

There is something new here though, that flip from high compliance to low compliance. It seems to happen in a shot.

Not all that new, I switched from high compliance to low compliance decades ago.

Share this post


Link to post
Share on other sites
31 minutes ago, Steam Flyer said:

Well, there ya go.

Instead of hooking up all those patients to ventilators, when they can no longer breath well enough to get oxygen into their blood, just get them up on their feet. Maybe play some MC Hammer tunes?

I'm sure there's an algorithm for that.

- DSK

I think I was talking about the things they do specifically to prevent pneumonia and other respiratory complications.

Share this post


Link to post
Share on other sites
1 hour ago, Grrr... said:

Sounds like what most hospitals tell you.  No matter how sick, you're almost always better off getting up and moving around if you can.  Being sedentary is a killer.

Very true. If you don't keep moving, you lose the ability to keep moving.

Share this post


Link to post
Share on other sites
1 hour ago, Grrr... said:

Pretty pathetic how you continue to minimize.

I'm not really sure what you want me to do here.

Six months ago while you didn't give a rat's ass about any of this, I was working on the public health problem of air pollution on healthy lungs, now I still am. Am I supposed to cry in the staircase with you?

Share this post


Link to post
Share on other sites
1 hour ago, phillysailor said:

I’m remaining skeptical of any reports of treatments which proclaim 0 fatalities as a result of their therapy. So far, they haven’t borne scrutiny very well.

YMMV

Are they supposed to fabricate data so it doesn't make you skeptical?

And it's not their "therapy." The therapy is the same therapy that has always been. It's an overhaul of the protocol. And what "scrutiny" have they not survived? The scrutiny that you just made up? It's been published in peer reviewed medical journals. Where has your scrutiny on their work published?

Share this post


Link to post
Share on other sites
2 minutes ago, mikewof said:

I'm not really sure what you want me to do here.

Six months ago while you didn't give a rat's ass about any of this, I was working on the public health problem of air pollution on healthy lungs, now I still am. Am I supposed to cry in the staircase with you?

If only you knew half as much as you think you do about other people.

Share this post


Link to post
Share on other sites

Fuckin funni how much bullshit Mikey spins about his activities, he's done everything.  Now after none of his activities succeeded, he shills for a living on shitty forums.

  • Like 2

Share this post


Link to post
Share on other sites
1 hour ago, Steam Flyer said:

Well, there ya go.

Instead of hooking up all those patients to ventilators, when they can no longer breath well enough to get oxygen into their blood, just get them up on their feet. Maybe play some MC Hammer tunes?

I'm sure there's an algorithm for that.

- DSK

Don't hurt 'em Hammer!

Share this post


Link to post
Share on other sites
3 hours ago, astro said:

His point is to sow seeds of doubt about any subject that does not support the Trump administration.

Climate Change?  He says it's not caused by humans.

COVID-19? He says it's caused by everything else except the virus.  And it's not as deadly as the Flu.

He is a right wing troll who most likely does this same shit on other forums.

Mike's a lot of things, but right-wing isn't one of them.  If you actually think that, you really have him all wrong.

 

Share this post


Link to post
Share on other sites
4 minutes ago, frenchie said:

Mike's a lot of things, but right-wing isn't one of them.  If you actually think that, you really have him all wrong.

 

I thought you were smarter than that Frenchie.  He is reeling you in and you can't see it.

He is a professional.

Share this post


Link to post
Share on other sites
3 hours ago, mikewof said:

He talked about that in the article. When someone is dying, they'll put him or her on a ventilator, regardless the Time magazine article.

I mentioned some articles about a month ago that preferred noninvasive intubation.

This is something genuinely new. It's specific results from Germany that dropped the mortality from 60% to zero. It's specific protocol that hospitals can use today. And it recognizes the changing elastance. This isn't blase research that is just a recolor of something that everyone already knew.

That we can look back at an old video just shows that they were looking into it, but the doctor himself couldn't use that protocol. Now maybe they can.

You're using a very weird definition of "protocol".  It's not a set of rules that doctors slavishly follow.  Kyle-Sydell himself, in that interview, says "I've run into a great deal of resistance within my institution, which is not to say that anyone is trying to stymie the progress at all.

A doctors' specific response in a particular situation is informed by the protocol, but it's also customized according to the particular presentation of symptoms, etc.  And a given ICU's protocol is constantly getting adjusted as they figure things out.  It's a new disease, they're constantly learning things.  I've lurked some fascinating threads in the medical subreddits, where doctors discuss and share info on this new disease.  That's where I first saw his video. 

At the time, most ICUs were intubating way earlier than they normally would for ARDS, because that seemed the best approach at the time.  Patients with COVID-19 would often "decompensate" suddenly, out of nowhere.  Literally fine, talking to you, walking around, one minute; collapsed on the floor from lack of oxygen, the next.  And the usual/standard intermediate measures didn't seem to help, or at least not guard against that sudden crash in blood oxygen level. 

Also, non-invasive respirators (Cpap, bipap, HFNC) are aerosolizing  (so is intubation, but only during the actual insertion of the tube, not once it's inflated).  There's only so many negative-pressure rooms available, and (especially at the time) there's only so much PPE to go around.  So doctors in NYC & Seattle, who'd been dealing with it for a few weeks, were telling doctors in the midwest, where it hadn't hit yet, to intubate early on.  But then other doctors started linking that video.

All I'm trying to tell you is that this isn't a revolutionary new discovery; it's something they've been talking about for a month, that Time Magazine of all places had picked up on two weeks ago.  Ann fucking Coulter tweeted about it 2 weeks ago!  It's great that you're catching up, but I don't see why it needed its own thread, or why you're so shocked.  I've been tryinna tell you for a week it isn't bacterial pneumonia that's killing folks, that this disease is much weirder than that.  You didn't need a time machine, you just needed to be paying attention.  Here, I dug through my bookmarks; check it out:

https://www.medscape.com/viewarticle/928156#vp_3

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

https://www.ajtmh.org/content/journals/10.4269/ajtmh.20-0283

https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/uchicago-medicine-doctors-see-truly-remarkable-success-using-ventilator-alternatives-to-treat-covid19?fbclid=IwAR1OIppjr7THo7uDYqI0njCeLqiiXtuVFK1znwk4WUoaAJUB5BHq5w16pfc

https://www.statnews.com/2020/04/21/coronavirus-analysis-recommends-less-reliance-on-ventilators/

https://www.medscape.com/viewarticle/928513  

  • Like 1

Share this post


Link to post
Share on other sites
1 hour ago, astro said:

I thought you were smarter than that Frenchie.  He is reeling you in and you can't see it.

He is a professional.

I've known him a fair bit longer than I've known you...

Share this post


Link to post
Share on other sites
1 minute ago, frenchie said:

I've known him a fair bit longer than I've known you...

I just did a quick calculation.  If all of Mikey's past lives were true he would be at least 198 years old.

This gig on SA/PA must be the longest job he has had.

Share this post


Link to post
Share on other sites
5 hours ago, phillysailor said:

The coagulopathy is causing Heart-attack like conditions in folks with no atherosclerosis. Multiple PEs, and strokes, organ failure (kidneys, GI tract.)

5 minutes ago, frenchie said:

Also, non-invasive respirators (Cpap, bipap, HFNC) are aerosolizing  (so is intubation, but only during the actual insertion of the tube, not once it's inflated).  There's only so many negative-pressure rooms available, and (especially at the time) there's only so much PPE to go around. 

 

Well, as a lowly ex-Polly Sigh peep, all I can say for sure is that I do not know diddly-squat about this compared to Philly & Frenchie 

But I do know enough to send a check to help out a bit to the Greater NY front line heroes - Lesser NY too 

  • Like 1

Share this post


Link to post
Share on other sites
18 minutes ago, astro said:

I just did a quick calculation.  If all of Mikey's past lives were true he would be at least 198 years old.

This gig on SA/PA must be the longest job he has had.

I've never met him, but I've met people he knew in NY.  He posts under his own name.  You can google him, find the same desalinator project he's posted here.  You can find his linkedin page, his youtube page... he even once posted his phone number, for fuck's sake. 

The guy has no secrets, never mind a secret agenda.

  • Like 2

Share this post


Link to post
Share on other sites
6 hours ago, mikewof said:

He talked about that in the article. When someone is dying, they'll put him or her on a ventilator, regardless the Time magazine article.

I mentioned some articles about a month ago that preferred noninvasive intubation.

...    ...

You missed a lot of detail, and we talked about this some weeks ago

No doctor, ever, anywhere, justs "puts him or her on a ventilator" as some kind of random "fuck it, they're dying anyway" kind of move. There are very specific circumstance under which a patient is INTUBATED and put on a ventilator. Basically, it means that they can no longer breath for themselves, for any of lots and lots of reasons. People get put on a ventilator because they need it, and will die SOON without it.

Please explain more about this ventilating patients with a non-invasive intubation. I don't know much about this, all ears here.

- DSK

Share this post


Link to post
Share on other sites
16 minutes ago, frenchie said:

I've never met him, but I've met people he knew in NY.  He posts under his own name.  You can google him, find the same desalinator project he's posted here.  You can find his linkedin page, his youtube page... he even once posted his phone number, for fuck's sake. 

The guy has no secrets, never mind a secret agenda.

All true, except that if after you google him, you then use that information here and argue against him, you will be reported for stalking and banned.  Saw it happen.

Bit of a trap.

Share this post


Link to post
Share on other sites