11–20 of 123 posts
I'm an intensivist based in Sweden. From my perspective there is absolutely nothing new in this article. We have been using HFC for years if not decades.
We've converted a huge number of beds to negative pressure in order to maximize use of HFNC. Anecdotally, I feel like it works, but would be great to see a trial.
*major nyc health system
One of the most interesting parts of this press release, following it on other boards, is the immediate "We already do that. Nothing new here." That kind of reply would immediately lead me to think it was just a useless release, but then I see people posting comments along the lines of "No, we don't do that. In fact, we have a policy against doing that because of the danger of aerosolization" For my hacker/systems wo…
Sounds like a promising strategy to manage patients, assuming the hospital has the necessary negative pressure rooms, etc. Especially since ventilators don’t even seem to be very effective. We’ve been seeing stories last few days that the large majority (88%) of folks put on ventilators in NYC, end up dying.
Don't get me wrong, the fatality rate for intubated patients is going to be high. but probably more like 40-60%.
Sounds like a promising strategy to manage patients, assuming the hospital has the necessary negative pressure rooms, etc. Especially since ventilators don’t even seem to be very effective. We’ve been seeing stories last few days that the large majority (88%) of folks put on ventilators in NYC, end up dying.
If there is some bias in the study population, the overall rate can change quite a lot (for example, a possibility is that the weakest patients succumb in that period, with stronger patients coming off the ventilators after a longer period...).
One of the most interesting parts of this press release, following it on other boards, is the immediate "We already do that. Nothing new here." That kind of reply would immediately lead me to think it was just a useless release, but then I see people posting comments along the lines of "No, we don't do that. In fact, we have a policy against doing that because of the danger of aerosolization" For my hacker/systems wo…
Even better would be randomized experimental data that this was better than an alternative... 'It works' can mean lots of different things...
Unfortunately, in the middle of a pandemic, that's not going to happen with enough speed to prevent a lot of people dying.
The perfect can be the enemy of the good enough. We don't have to guess or learn about the mass of an electron; that's been well-established through great lab work. But not all decisions are like that. Many times the hardest decisions are those you make with incomplete and contradictory information ... and not making a decision is, in effect, making a decision. This is one of the things that's so interesting here. If it were simple yes/no, what's science and what's speculation, there wouldn't be much interesting learning or decision-making happening.
"The respiratory distress appears to include an important vascular insult that potentially mandates a different treatment approach than customarily applied for ARDS." https://twitter.com/jama_current/status/1253722428053823492
I think we can safely reopen fully now and treat any serious cases using our existing healthcare systems in combination with this kind of new knowledge.
The longer we 'suppress the curve', when we are already far below hospital system capacity, the more economic and social damage we cause unnecessarily.
I'm an intensivist based in Sweden. From my perspective there is absolutely nothing new in this article. We have been using HFC for years if not decades.
Our* guidance has been HFNC only in negative pressure rooms because of the aersolization risk. We've converted a huge number of beds to negative pressure in order to maximize use of HFNC. Anecdotally, I feel like it works, but would be great to see a trial. *major nyc health system
With treatment so simple, we have effectively removed the healthcare system as a bottleneck on the rest of society. I think we can safely reopen fully now and treat any serious cases using our existing healthcare systems in combination with this kind of new knowledge. The longer we 'suppress the curve', when we are already far below hospital system capacity, the more economic and social damage we cause unnecessarily.
With treatment so simple, we have effectively removed the healthcare system as a bottleneck on the rest of society. I think we can safely reopen fully now and treat any serious cases using our existing healthcare systems in combination with this kind of new knowledge. The longer we 'suppress the curve', when we are already far below hospital system capacity, the more economic and social damage we cause unnecessarily.
Stronger pandemic response yields better economic recovery. http://news.mit.edu/2020/pandemic-health-response-economic-r...