How Coronavirus Kills: Acute Respiratory Distress Syndrome (ARDS) & COVID 19 Treatment
Why Hacker News recommends it
In early 2020 HN commenters linked it as a clear explanation of how the virus kills through lung failure and why ventilator choices matter, notably in ventilator design threads.
What it is
A pulmonologist and critical care physician explains how COVID-19 can lead to pneumonia and acute respiratory distress syndrome. He covers evidence-based ARDS treatments such as low tidal volume ventilation.
Recommended by 3 HN commenters across 2 different months, 2020 to 2020.
What Hacker News said
Recommends hybrid_cluster · 2020-01 · on “WHO declares coronavirus outbreak a public health emergency”
One of the main causes of death of the new coronavirus seems to be Acute Respiratory Distress Syndrome (ARDS). This can be treated fairly effectively with ventilation, but such treatment would obviously require a bed, ventilation system, and attentive nurses, at the very least. It's easy to imagine how these requirements may currently not be met for all patients with ARDS symptoms in Wuhan. For more info on ARDS and treatment in the context of the current pandemic, see this informative explanation: [this video]
Recommends taf2 · 2020-03 · on “Low-Cost Arduino-Based Ventilator”
I really like this as DIY - I also found this video [this video] - explaining how the virus eventually kills by causing failure of the lungs. After explaining the functional parts he goes on to explain what seem like some interesting things to consider when designing a ventilator with respect to how they were used during the SARS outbreak. e.g. tidal forces causing iteration and more inflammation, which then cuts off more air flow. So thinking about how you maintain a constant air pressure instead of more pushing force... at least the explanation made sense intuitively but I'm not a doctor and don't know if this video or your Ventilator are safe - but I do like the DIY aspect of it and figure thi
Recommends brigandish · 2020-03 · on “E-VENT: Emergency ventilator design toolbox”
Thanks. I'm not a doctor so I could be wrong (and happy to be corrected) but from my understanding the problem with those techniques in this situation is that they are for clearing mucus from the lungs (in the bronchi and broncioles) not from alveoli, because mucus isn't the type of fluid in the alveoli. Hence, they'd have little effect. This video[1] goes into what happens when you have ARDS caused COVID and how it will be treated. It shows why machines like CPAP aren't appropriate too. [1] [this video] How Coronavirus Kills: Acute Respiratory Distress Syndrome (ARDS) & COVID-19 Treatment
Cites lovehashbrowns · 2020-02 · on “Coronavirus Forces World’s Largest Work-from-Home Experiment”
For coronavirus, it doesn't necessarily have to be the death rate as of this moment that should cause worry. Coronavirus can cause ARDS, described here: [this video] Treating ARDS in a handful of cases isn't so bad. It's treating ARDS in hundreds of thousands of people that's very very bad. Hospitals can quickly become full and hospitals also rely on supply chains for materials, which would also become overwhelmed. I'm not saying panic is the right thing to do, because it isn't, but what I am saying is that the quarantines aren't excessive and there's a reason why governments are paying attention.
Cites DoreenMichele · 2020-04 · on “Some doctors moving away from ventilators for virus patients”
Someone linked me to this a few days back: [this video] It explains how they pressurize the lungs to try to keep the alveoli open and why that's very problematic, even when it is only short term. It is so problematic, they sedate people on ventilators so they won't pull the tubing out. It sounds just really gruesome and like a brute force method that can't help but cause serious problems for delicate tissues if you use it for more than a fairly short period of time, which is the norm but is not how it is being used for Coronavirus cases. Oxygen delivery is a complicated thing and I think taking a mechanical approach when mechanics may not be the actual problem is likely misguided.
Cites thebigspacefuck · 2020-05 · on “Nvidia Releases Low-Cost, Open-Source Ventilator Design”
From what I understood, with ARDS, it was necessary to medically induce a coma/paralysis and, in order to have highest chances of survival, required staff to monitor and posture patients every 8 hours. Even if ventilator supply was not a constraint, would there be other constraints caused by staffing that would limit effectiveness of ventilators? Note: I am NOT a doctor or involved in health or medicine in any way. My source for this information is this MedCram lecture on Youtube: [this video]