So, I was a bit wrong in my last post; upon looking at more studies it looks like non-invasive ventilation *does* reduce the risk of needing intubation.https://srconstantin.github.io/2020/03/20/non-invasive-ventilation.html …
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It looks like non-invasive ventilation cuts the risk of intubation in half, relative to standard oxygen therapy, if you look at all adult cases of acute respiratory distress (which includes things like COPD, pulmonary edema, pneumonia.)
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NIV is still going to aerosolize the virus, so it's still dangerous to do in hospitals or any public setting, but it might be valuable at home for people who are already self-quarantining, in the event that we run out of ICU space.
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if the hospitals are *not* overrun, your best bet if you can't breathe is to go to a hospital; they are better prepared to deal with the worst-case scenarios than anything you could rig up at home.
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But it looks like the US and many other countries are on track to run out of ICU space. So "plan B" measures are relevant.
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There are considerations that make home NIV for COVID19 look worse than hospital NIV for all respiratory failure. COVID19 causes worse ARDS and more patients (40%) need intubation. Also we’d expect home care & rapidly prototyped devices to be worse than hospital care & devices.
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However 50% reduction in intubation rate has a lot of wiggle room to get worse before it’s “basically no benefit” relative to *nothing*. The point of comparison is “hospitals full, no treatment, die at home.”
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End of conversation
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