Wikipedia:Reference desk/Archives/Science/2020 July 28

= July 28 =

"In the hospital being treated with oxygen for his lungs"
(This is about Herman Cain.) What does that phrase mean? Supplemental oxygen usually doesn't require hospitalization. Plus if he is conscious and able to speak, I figure they'd have him say something to his well-wishers on TV, so it sounds like he's still not in great shape. Could it mean intubation? Hyperbaric oxygen? Or are they just being vague about his condition? Thanks. 2601:648:8202:96B0:0:0:0:5B74 (talk) 05:59, 28 July 2020 (UTC)
 * The last sequence of tweets about Cain's condition does not provide enough information to be sure. They go, "But he is still in the hospital being treated with oxygen for his lungs. [...] Re-strengthening the lungs is a long and slow process, and the doctors want to be thorough about it." The lungs being affected by COVID-19 can lead to acute respiratory distress syndrome, for which hyperbaric oxygen treatment is being used, and since this would require continued hospitalization, this appears to be a definitely possible explanation. But we can't be sure without further information. --Lambiam 08:56, 28 July 2020 (UTC)
 * Thanks, doesn't sound like hyperbaric therapy is usually given 24/7. It's done with a mask on, though. If it's just hyperbaric then from the descriptions I'd expect he is conscious and could smile and wave for a camera, even if he can't talk.  Could be be on ECMO?  I guess we will just have to wait for updates.  2601:648:8202:96B0:0:0:0:5B74 (talk) 21:35, 28 July 2020 (UTC)


 * Given that his death was announced this morning, I'd say his condition 3 days ago was probably not good. --OuroborosCobra (talk) 16:07, 30 July 2020 (UTC)

Why do they put tubes in you instead of an external mask or dialysis but lung stuff instead of dialysis organs (if alveoli are too fucked to work)?
Maybe there's way too few lung analog of dialysis machines but why not just glue a damn oxygen mask to the patient instead of lubricating a tube down their throat? If the tube machine moves the diaphragm for the patient with pressure cycles then how hard could it be to connect a fighter plane-style mask to it instead? Sagittarian Milky Way (talk) 18:36, 28 July 2020 (UTC)
 * I suspect the major reason is that with external positive pressure, you would push all kinds of undesirable material into the lungs - in particular parts of the contents of the stomach, if the patient throws up. Such events almost always lead to (an additional) pneumonia, which is a serious risk for patients (which is a polite way of saying "they die like flies"). Also, as far as I know, "fighter pilot masks" don't use significant (or any) positive pressure, they just provide oxygen and rely on the normal breathing of the pilot to move the breathing gas. --Stephan Schulz (talk) 19:09, 28 July 2020 (UTC)
 * Yes, the point is that such machines are needed when the patient cannot breathe alone. Applying pressure externally would probably not bring any air into the lungs because the throat could lock closed with undesirable short term consequences. But perhaps you mean this would quickly free one more bed, wouldn't it?
 * And sorry but I fail to understand what you mean with the second part of your question '.. or dialysis but lung stuff instead of dialysis organs' 2003:F5:6F0C:9500:2DDB:7E1A:35F8:B774 (talk) 19:18, 28 July 2020 (UTC) Marco PB
 * I think the second part may be in some way a question about extracorporeal membrane oxygenation. - Nunh-huh 19:42, 28 July 2020 (UTC)

I happen to have personal experience with this. I recently spent 6 days on a respirator. The first 4 days I was kept unconscious. Then 2 days on the respirator. Then 4 days on Non-invasive ventilation. Then another 2 days with just supplemental oxygen. --Guy Macon (talk) 19:45, 28 July 2020 (UTC)
 * Why'd they wake you up for only 2 days just to make you uncomfortable? Why not wait till after intubation? Did you catch it while maskless? Sagittarian Milky Way (talk) 21:43, 28 July 2020 (UTC)
 * Catch it while maskless? Oh, I get it. You thought I had Covid-19. I had cardiac arrest caused by an undetected electrical problem in my heart. As for why they woke me up, here is how it works. You can breathe on your own for a couple of minutes, then you can't and the respirator takes over. You rest, then do it again. You can lift your arm maybe an inch, then it falls back exhausted. You rest, then do it again. That's your job. Keep it up and eventually you can roll on your side. More exercise and eventually you can sit upright for a whole minute. Skipping a bunch of steps, eventually you can walk. They wake you up so you can start working at getting your strength back. --Guy Macon (talk) 23:02, 28 July 2020 (UTC)
 * So that's what it's called, extracorporeal membrane oxygenation. So probably a reason why that's a laster resort than intubation is that they apparently have to stab the aorta and vena cava or something, in dialysis you don't have to clean a gallon and change of blood before the patient suffocates so it can be slower and you can stab less extreme locations so it's more routine. Sagittarian Milky Way (talk) 21:43, 28 July 2020 (UTC)
 * Usually known as its acronym, ECMO. Yes, ventilators are less troublesome and less dangerous, and have been around longer, so they would be the default. - Nunh-huh 22:28, 28 July 2020 (UTC)
 * And if you can handle Non-invasive ventilation instead of the tube down your throat, they do that. --Guy Macon (talk) 23:02, 28 July 2020 (UTC)
 * "Overall, 19% of hospitalised [COVID-19] patients require non-invasive ventilation, 17% require intensive care, 9% require invasive ventilation, and 2% require extracorporeal membrane oxygenation". BMJ Best Practice Alansplodge (talk) 16:30, 29 July 2020 (UTC)
 * Again from personal experience, that non-invasive ventilation was a huge help. I was working really hard at breathing on my own, knowing that doing the breathing exercises the physical therapist gave me was the best way to get out of that hospital room. But my chest muscles got super tired. When that happened, I put the mask back on and the machine did most of the work, pushing air in and pulling it out and giving my muscles time to rest up until I could try again. Plus, I got to do a great Darth Vader impression... :) --Guy Macon (talk) 17:14, 29 July 2020 (UTC)