Yes, definitely in California; where we have avoided the worst. Not in NYC, Boston, Detroit, New Orleans, where they truly are overwhelmed.
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Replying to @elonmusk @Bob_Wachter
I am a medical resident in Boston and we are still overwhelmed. We have had to significantly expand our ICU capacity across the city and the cases continue to increase. Patients who are mechanically ventilated are often on the ventilator for weeks before being extubated.
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I had an idea since I was reading about the ventilator debate. Could something similar to dialysis be used to oxygenate the blood instead of cleanse it?
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Replying to @grepmeded @dschless and
Is that a reasonable alternative to the ventilator?
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Replying to @gamblin_ashley @dschless and
still need a ventilator on top of many other things. it’s certainly not easy and extremely resource intensive. only viable for very select patients in resource rich academic environments and will not scale well in mass casualty / pandemic scenarios.
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Replying to @grepmeded @dschless and
I think I was looking for something less resource intensive. Something that would directly increase oxygen saturation without messing with lung function. For example, the same experience one would have donating platelets but I guess that doesn’t exist.
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Replying to @gamblin_ashley @dschless and
it’s a great thought. In practice you need gardenhose size catheters and lots work to keep the blood from clotting and other complications. need to ventilate lungs to allow recovery, prevent pneumonia etc. much much more more complex than standard hemodialysis.
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Replying to @grepmeded @dschless and
COVID-19 presents atypically with ards as in flexible and non hardened...respiration seems normal...so why not just add the oxygen that is needed and let the lungs function on their own.
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“just add the oxygen” is the hard part! Hemodialysis replace the kidneys- think how often you urinate. Breathing is continuous. Replacement via oxygenation circuit 24/7 is not natural and can be very dangerous.
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