Any medics/scientists on here can answer this for me...

These ventilators that replace the Iron lung...
Now obviously what I suggest below does not work as far greater minds would have already have developed this so my question is more about why it doesn't ..

The lungs provide oxygen via the heart pumping oxygen rich blood to the various organs throughout the body and when the lungs are under attack from a virus as is the case with Covid 19 providing oxygen enriched, warmed and humid air to the lungs not only assist the body but presumably also provides an 'hospitable' environment for the virus itself. Many deaths apparently result from organ failure due to lack of oxygen and most lung damage results not from the virus but the body's own defence mechanism causing inflammation.
Soo.... in a similar way to dialysis machines, why is there no device that can take the blood from an appropriated vein and externally enrich it with oxygen/removing CO2 and then return it to a major artery thus reducing the strain on the lungs which are congested and inflamed by the body's own defence mechanism? Pumping oxygen into damaged lungs with reduced volume dead cells seems a relatively inefficient way of oxygenating the circulatory system.

 

I'm neither a medic nor a scientist...as some of my post probably prove...but the reoxygenation of blood outside the body is being experimented with somewhere, unfortunately I can't find the link, but there were some technical difficulties.

 

Having asked my dentist student daughter the points she makes are:


So you'd have to give them someone else's blood so there is always a health risk (and shortages)

You would also keep replicating the virus , are you talking about bringing back leeches and blood letting to get rid of the virus first?

It's probably been explored as a possibility with other viruses like HIV?

 

Does dialysis require addtional blood? I thought dialysis fluid consisted of the patinets own blood and a solution (containing glucose) I thought the point was to 'clean' the patients own blood and not replace it. I suspect apart from glucose aiding the body it would 'supplement' the blood supply to prevent drop in BP due to the amount outrside the body in the tubes feeding the dialysis unit and the blood in the unit itself and machine. Again I know little of medical procedures. The idea of oxygenating blood should not really require a transfusion other than plasma to make up the bulk (although it is red blood cells that carries oxygen and removes CO2)

 

From what I vaguely remember from my biology class, isn't the oxygen in the lungs converted to Haemoglobin which is the oxygen carrying molecule in the blood? Would injecting oxygen straight into the blood stream produce the same results? I've no idea.

 

Leeches have been making a return to medicine over the last 20 years. There are some use cases for them around improving blood flow after plastic surgery.

https://www.ouh.nhs.uk/patient-guide/leaflets/files/32855Pleech.pdf

 

I'm a cardiovascular scientist so this is not really my remit but hope it helps...

There is a procedure known as extra corporeal membrane oxygenation (ECMO) which places the patients own blood through a mechanical bypass - from what I have read, in the UK there a 5 centres which perform veno-venous ECMO on adults (there are additional centres for children).

In Covid-19 patients there is still too little data to suggest if ECMO improves survival of patients with, or progressing into, acute respiratory distress syndrome. Some data acquired in China shows there is no benefit of patients on ECMO vs. those on standard mechanical intervention but all of the study sample sizes are quite small - in one study 5/6 patients receiving ECMO died. In theory, whilst the body is receiving oxygenated blood by relieving the lungs of their function, there is still a severe inflammatory response and ECMO itself can interfere with the natural inflammatory response of the body. Also, NHS England has recommended that patients with the most severe symptoms (with underlying health problems) are not referred for ECMO.

 

That's sounds sensible, so I googled it and got this.... It sounds like expensive equipment requiring specialist staff which I suspect would only be available to a select few.
Extracorporeal Membrane Oxygenation (ECMO)
ECMO stands for extracorporeal membrane oxygenation. The ECMO machine is similar to the heart-lung by-pass machine used in open-heart surgery. It pumps and oxygenates a patient's blood outside the body, allowing the heart and lungs to rest. When you are connected to an ECMO, blood flows through tubing to an artificial lung in the machine that adds oxygen and takes out carbon dioxide; then the blood is warmed to body temperature and pumped back into your body.

RELATED CONDITIONS
Heart Failure
There are two types of ECMO. The VA ECMO is connected to both a vein and an artery and is used when there are problems with both the heart and lungs. The VV ECMO is connected to one or more veins, usually near the heart, and is used when the problem is only in the lungs.

USCF is also now using a smaller portable ECMO device that is light enough to be carried by one person and can be transported in an ambulance or helicopter, making it possible to provide ECMO relief in emergency cases.

When is ECMO used:

• For patients recovering from heart failure, or lung failure or heart surgery.
• As a bridge option to further treatment, when doctors want to assess the state of other organs such as the kidneys or brain before performing heart or lung surgery.
• For support during high-risk procedures in the cardiac catheterization lab.
• As a bridge to a heart assist device, such as left ventricular assist device (LVAD).
• As a bridge for patients awaiting lung transplant. The ECMO helps keep tissues well oxygenated, which makes the patient a better candidate for transplant.

 

What you describe sounds very much like ECMO. Only a few hospitals in this country have it, including Leicester and Manchester. Has quite high complication rates including bleeding, which explains why it is used only if mechanical ventilation fails https://en.m.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation

 

nothing to add to the above

 

About a month ago, NHS Doctors were saying something similar,in that patients didn't need ventilators,as Post Mortems revealed ventilatipn had in some cases led to premature death. They believed that using Oxygen only was benficial and were worried about supplies. I would say that everyone around the world is learning on the job about how COVID -19 affects people ,only at the end will there be a clearer picture. Medical staff are and will take a holistic pragmatic approach to their patients, hoping that this will lead to recovery.

 

I heard a week or so ago that some patients were responding well with treatment for blood clotting rather than lung problems. So anti-coagulants instead of ventilators.

 

I don't think its as simple as sweepingly saying 'patient's didn't need ventilators', as mechanical ventilation is still the primary treatment option for the most sickest patients but it's a catch 22 situation - patients dying on mechanical ventilation are often the sickest ones, who (sadly) would have probably died regardless of the intervention. It appears now that medics are re-thinking both when to put patients on mechanical ventilation and which patients are best suited to that method e.g. if patients can survive on non-invasive ventilation such as CPAP then they remain on that unless they deteriorate. The only true way we will ever know if mechanical intervention is detrimental is by comparing severe COVID-19 patients randomised to either receive or not receive ventilation - an unethical study which would never get approval.

Regarding the idea behind anti-coagulants as a treatment option, there is some evidence to suggest severely ill patients receiving low molecular weight heparin had a better prognosis and the incidence of coagulation 'dysfunction' is significantly higher in patients who don't survive vs. those that do. However, one of the activators of the coagulation cascade is the 'cytokine storm' which occurs due to the viral infection, so it's unlikely that anti-coagulation therapy alone will suffice.

 

I've got a soda stream going begging int kitchen if anyone wants to experiment

 

and I've just bought a new hosepipe so the old ones spare - and there's a footpump in the garage that just needs a new gauge on it if that will help too.

 

Not certain about this but I think covid 19 affects both lungs whereas with pneumonia only one lung is affected initially.

Why are older people more badly affected - is it because their lungs are older and not 'efficient' or is there something else going on?

 

I claim my £5, you are Donald Trump.

 

New info from Dr.friend .
In yesterday's Manchester Evening news, there was an article about Dr Catherine Briggs, GP and head of Stockport CCG. She like me had the mild Covid 19,so didn't require hospitalisation. She is taking part in a trial with NHS blood transfusion service. They are extracting her plasma,as this is rich in Covid-19 anti-bodies to be used with patients who are seriously ill with the virus. Her red blood cells are then returned via transfusion,the process doesn't take long. It's early days in this trial but initial results are good at maintaining health not curing the virus. You can donate plasma up to 28 days after feeling well, following infection. This is a common way of fighting infections using the bodies own defence system, except using anti-bodies donated by someone else. This is one of the coordinated approaches being used worldwide,by medical research teams overseen by Oxford university for one.
Ignore what the politicians say, they know nothing and don't or won't understand what advice is given to them,especially Trump.
Hope this adds to what is a very interesting thread. The advances we have made in the last 30 years in treating HIV and Cancers, come from a multi layered approach. There often isn't a magic one size fits all, but rather lots of existing processes added together,become very powerful.

 

Wow!! I know this BB is full of diversity but that was a very detailed and explicit explanation. SO whilst my idea was not original (which I never expected it would be) disappointingly it is not revolutionary or apparently and effective way forward.
Thanks for the clarification.

 

From what I remember many years ago watching a murder mystery drama injecting oxygen or any gas direct into the bloodstream is likely to kill due to causing an air embolism (not what I was suggesting)