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Old 03-25-2020, 09:24 AM
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Respirator Question


There is a shortage of respirators, and ramping up production is time consuming.

Is there any reason the old school iron lung with an oxy mask can't be used?
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Old 03-25-2020, 09:40 AM
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How many iron lungs are lying around waiting to be called to action?
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Old 03-25-2020, 10:52 AM
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A very, very tiny percentage of people are still using iron lungs, and those are needed for, well, those individual people. And they struggle to get parts needed for repair/replacement. Excusing the question of whether an iron lung would even help (I'm not a doctor or, er, iron lung expert), new machines would not be made in time to help with this, and most of the existing ones are in museums (the one at my local museum creeps me out).
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Old 03-25-2020, 11:50 AM
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Do you mean respirator or ventilator?
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Old 03-25-2020, 12:28 PM
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I think itís clear from context that the OP meant to say ďventilator.Ē

I also think this is an insightful question. Itís true that ventilator production capacity is being ramped up as fast as possible, but not fast enough. And although there are no warehouses full of iron lungs in waiting, thatís not the point.

The production lines that lend themselves to building throwback iron lungs are rarely suited to manufacturing emergency ventilators. if a large-scale metal fabricator (e.g., Sub Zero) can ease the ventilator crisis by cranking out a few hundred throwback iron lungs, that sounds good to me.

Iím not saying thatís especially feasible, but I do think the question might have been a little more nuanced than it seemed at first.
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Old 03-25-2020, 02:08 PM
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You can find iron lungs in historical museums.
I'd think a ramped up CPAP/BIPAP with oxygen supply might be easier to find/make in bulk.
Those old iron lungs were huge!
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Old 03-25-2020, 02:32 PM
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Originally Posted by aruvqan View Post
There is a shortage of respirators, and ramping up production is time consuming.

Is there any reason the old school iron lung with an oxy mask can't be used?
If you have the oxy mask, why would you need the iron lung? Unless the patient is in a state of paralysis, which might be the case with polio, but (to the best of my knowledge) not with COVID-19!
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Old 03-25-2020, 02:53 PM
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If you have the oxy mask, why would you need the iron lung? Unless the patient is in a state of paralysis, which might be the case with polio, but (to the best of my knowledge) not with COVID-19!
Unfortunately, an oxygen mask just provides passive ventilation. Patients with ARDS, the respiratory failure sometimes caused by severe COVID-19, require strong positive pressure ventilation in order to adequately oxygenate their blood. Simply breathing higher concentrations of oxygen via a mask is insufficient, as is the negative pressure ventilation which you get with an iron lung. ARDS is a much worse condition than temporary paralysis of the respiratory muscles.

Last edited by Shmendrik; 03-25-2020 at 02:53 PM.
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Old 03-25-2020, 03:18 PM
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Unfortunately, an oxygen mask just provides passive ventilation. Patients with ARDS, the respiratory failure sometimes caused by severe COVID-19, require strong positive pressure ventilation in order to adequately oxygenate their blood. Simply breathing higher concentrations of oxygen via a mask is insufficient, as is the negative pressure ventilation which you get with an iron lung. ARDS is a much worse condition than temporary paralysis of the respiratory muscles.
Ah, I stand corrected. So, you increase the amount of oxygen available to the blood by increasing the pressure inside the lungs?

Would a hyperbaric chamber, like those used in saturation diving, be of any use? Those can be built fairly big, to accommodate a dozen or more inhabitants! Decompression while passing through the airlock wouldn't be a big problem, unless we're talking several atmospheres!
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Old 03-25-2020, 03:55 PM
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Here is an idea I saw in the New Haven newspaper today; split the hose off a ventilator to feed air to two or even four patients. It's never been done for the long term, though, so it's not known if it will work. And the patients need to be of similar size.
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Old 03-25-2020, 05:47 PM
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If you have the oxy mask, why would you need the iron lung? Unless the patient is in a state of paralysis, which might be the case with polio, but (to the best of my knowledge) not with COVID-19!
The lungs are less efficient when full of fluid. The ventilator for ventilation, the oxygen to improve oxygenation.
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Old 03-25-2020, 10:27 PM
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Perfect, just the type of answers desired =)
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Old 03-26-2020, 01:14 AM
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Originally Posted by Dewey Finn View Post
Here is an idea I saw in the New Haven newspaper today; split the hose off a ventilator to feed air to two or even four patients. It's never been done for the long term, though, so it's not known if it will work. And the patients need to be of similar size.
This is under actual development. It is essentially a Y-splitter, much as might be used to hook up two water hoses to a single tap. The design is 3-D printed from a previously medically approved material, and capable of offering filtration.

Emergency approval has already been received. The design passed preliminary testing on a teaching mannequin. This should be something that can be ramped up quickly - really.

In trying times, think creatively. While 30,000 ventilators might be preferred for New York state, the need is to be capable of ventilating 30,000 patients. If that can be done with fewer than 10,000 ventilators it could stretch our already thin resources to maximize patient outcomes.

Last edited by Iggy; 03-26-2020 at 01:17 AM.
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Old 03-27-2020, 03:32 PM
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NewYork-Presbyterian Hospital is sharing a ventilator between two patients this week. They're not actually short of ventilators yet but want to be ready when it is a crisis.

Also, a doctor in Italy is doing it because it is a crisis there.

Last edited by Dewey Finn; 03-27-2020 at 03:34 PM.
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Old 03-27-2020, 04:58 PM
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Originally Posted by Ignotus View Post
Ah, I stand corrected. So, you increase the amount of oxygen available to the blood by increasing the pressure inside the lungs?

Would a hyperbaric chamber, like those used in saturation diving, be of any use? Those can be built fairly big, to accommodate a dozen or more inhabitants! Decompression while passing through the airlock wouldn't be a big problem, unless we're talking several atmospheres!

I would like to join the Ignotus question. Wouldn't a standard 3 atm hyperbaric chamber provide (almost) 3 times the oxygenation - and with no pressure differentials that can rupture alveoles as in ventilation ? Of course hyperbaric chambers have variable oxygen percentage up to 100%.
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Old 03-27-2020, 05:55 PM
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Originally Posted by doubleminus View Post
I would like to join the Ignotus question. Wouldn't a standard 3 atm hyperbaric chamber provide (almost) 3 times the oxygenation - and with no pressure differentials that can rupture alveoles as in ventilation ? Of course hyperbaric chambers have variable oxygen percentage up to 100%.
The problem is the need to force air into the lungs past passages filled with thick mucus, fluid, etc. Its not that there isnt enough oxygen in the air, its that your diaphragm cannot exert enough force to get air past those blockages. Simply increasing oxygen levels and or atmospheric pressure does not achieve this.
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Old 03-27-2020, 06:59 PM
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Moved to the Quarantine Zone.
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Old 03-27-2020, 07:55 PM
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Originally Posted by doubleminus View Post
I would like to join the Ignotus question. Wouldn't a standard 3 atm hyperbaric chamber provide (almost) 3 times the oxygenation - and with no pressure differentials that can rupture alveoles as in ventilation ? Of course hyperbaric chambers have variable oxygen percentage up to 100%.
I see the claim that the first use of a hyperbaric oxygen chamber was to treat someone with the flu. And I read that oxygen poisoning is one potential result of hyperbaric oxygen....

I also remember that at sufficient pressure and concentration, you don't need to use your lungs -- you can breath through your skin. I can't find that now. Anyone?

But I think that the number of available hyperbaric chambers is tiny.
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Old 03-28-2020, 12:31 AM
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How many iron lungs are lying around waiting to be called to action?
Given all the anti-vaxxers in the world, it may not be a bad idea to start making a few....
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