Helmet-based ventilator alternative
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@George-K what do you think of this:
(Hat tip @wtg)Doctors at the University of Chicago are using a helmet to treat COVID-19 patients who are struggling to breathe.
The hospital's COVID-19 ICU is using the spacesuit-like helmet as an alternative to a ventilator.
"It is like a hyperbaric oxygen chamber," said UChicago Medicine Dr. Bhaki Patel.
Dr. Patel said the hospital is using the helmet "as a strategy to prevent an intubation or a ventilator" for five patients so far.
Two of the nation's top pulmonary doctors, Dr. Patel and Dr. John Kress, have studied the helmets for years in Chicago. The duo found that the device helps critically ill patients breathe better without being intubated.
The clear plastic FDA-approved helmet surrounds the patient's head and pumps oxygen into their lungs at high pressure.
"The way that it feels is if you go on an airplane and they pressurize the cabin," Dr. Patel said.
The doctors said patients who use the helmet instead of a ventilator spend less time in the ICU and have a better rate of survival.
Video and more here:
https://abc7chicago.com/corona...is-cases-in/6093782/
News coverage from 2016
https://www.sciencedaily.com/releases/2016/05/160516103252.htm -
This makes a lot of physiologic sense if you accept the theory that COVID-19 pneumonitis is not ARDS. You oxygenate the patients by providing an extremely high-flow oxygen-rich environment. Perhaps more importantly, you don't use positive pressure to move air into the lung. Instead, normal negative pressure (when you inhale) draws air into the lung. If the lungs are compliant, as I've commented elsewhere, this would be a good and reasonable alternative.
The other thing that people are doing is putting patients prone. "Proning" patients in the ICU has been a long-standing therapeutic modality, the thinking is that it redistributes bloodflow to non-diseased portions of lung. However, it's always been done on patients who are being ventilated. Now, they're trying it with spontaneously breathing patients. Sometimes, if one lung is worse than the other, patients are positioned laterally, with the "good" lung down. Improvement is seen within hours, sometimes minutes.
This is all out-of-the-box thinking, and I'm excited to see it.
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My first thinking on this disease is it would be better to get it early when the health system is not overwhelmed. Now I am thinking later as we are learning how better to help patients in distress.
“I am fond of pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.” ~Winston S. Churchill
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My first thinking on this disease is it would be better to get it early when the health system is not overwhelmed. Now I am thinking later as we are learning how better to help patients in distress.
@Mik Had exactly the same thought. The entire world is working on this problem. Who knows what we'll learn in another month.
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We are at last starting to look like sci-fi told me Medical treatments would look like!
Next step? Big glass tanks filled with some medicinal gel!
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My surgeon friend and I were talking about how to get oxygen into patients without using a ventilator. This is obviously a good and simple solution (hope it works!). However, he suggested hyperbaric chambers.
I suppose that would work as well, but if you think ventilators are in short supply....
Then he said, "Airplanes. Widebody airplane fuselage could become a very large hyperbaric pressure chamber. Maybe not more than 2 atm but, hey it might be useful."
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My first thinking on this disease is it would be better to get it early when the health system is not overwhelmed. Now I am thinking later as we are learning how better to help patients in distress.
@Mik said in Helmet-based ventilator alternative:
My first thinking on this disease is it would be better to get it early when the health system is not overwhelmed. Now I am thinking later as we are learning how better to help patients in distress.
Not at all > after a treatment > after the peak > before the peak > during the peak.
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This makes a lot of physiologic sense if you accept the theory that COVID-19 pneumonitis is not ARDS. You oxygenate the patients by providing an extremely high-flow oxygen-rich environment. Perhaps more importantly, you don't use positive pressure to move air into the lung. Instead, normal negative pressure (when you inhale) draws air into the lung. If the lungs are compliant, as I've commented elsewhere, this would be a good and reasonable alternative.
The other thing that people are doing is putting patients prone. "Proning" patients in the ICU has been a long-standing therapeutic modality, the thinking is that it redistributes bloodflow to non-diseased portions of lung. However, it's always been done on patients who are being ventilated. Now, they're trying it with spontaneously breathing patients. Sometimes, if one lung is worse than the other, patients are positioned laterally, with the "good" lung down. Improvement is seen within hours, sometimes minutes.
This is all out-of-the-box thinking, and I'm excited to see it.
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@brenda said in Helmet-based ventilator alternative:
These look similar to what was shown in pics from Italy.
Indeed!
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