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Thread: Coronavirus thread

  1. #3781
    Remdisivir clinical trial underway:

    LEBANON, N.H. —
    A clinical trial to research a medication to slow the progression of COVID-19 is now underway at Dartmouth-Hitchcock Medical Center.
    Some patients at Dartmouth-Hitchcock who have tested positive for the virus are receiving a medication called remdesivir. Doctors said they are hopeful it will help.
    A team of researchers at the hospital are working with more than 90 other clinical sites around the world in this trial.
    “It was our priority and we worked straight eight days on the studies to make sure it was going to open as fast as we could get it to open, so that we could have it as an option for our patients,” Leigh Burgess, vice president of Dartmouth-Hitchcock Research Operations, said.
    Researchers said the anti-viral drug was developed during the ebola outbreak and has potential to help patients battling COVID-19.
    “There are really very limited treatment options and this has the most-promising treatment option identified by the World Health Organization,” Richard Zuckerman, principal investigator, said.

    https://www.wmur.com/article/new-ham...erway/32011729

  2. #3782
    Site Supporter NEPAKevin's Avatar
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    Just F***ing Great.

    So, because my "essential" job isn't wonderful enough, I just had to lay off an employee who is exposed to someone who tested COVID-19 positive and apparently didn't think it important to inform anyone or self quarantine or practice social distancing or anything like that. Small wonder this shit is spreading the way it is.

  3. #3783
    THE THIRST MUTILATOR Nephrology's Avatar
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    Quote Originally Posted by 45dotACP View Post
    The immovable fever is something that we've noticed as a trend at work.

    The hydroxychloroquine can cause some nasty diarrhea. I am glad to hear you're recovering man. Keep on feeling better.

    Has your appetite improved?

    Sent from my moto g(6) using Tapatalk
    Are you guys using ECMO yet? I think we only have 1 on circuit rn. I'll post our census shortly

    Edit: 2 on circuit, +1 overnight

  4. #3784
    THE THIRST MUTILATOR Nephrology's Avatar
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  5. #3785
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    Quote Originally Posted by Nephrology View Post
    Are you guys using ECMO yet? I think we only have 1 on circuit rn. I'll post our census shortly
    I could be mistaken but a buddy in our Adult Surgical Heart Unit tells me we have something like 7 or 8 ECMO circuits running and more than half are COVID-19 patients.

    Unrelated, but a lot of the younger patients throw PEs to the point where some of our intensivists have been empirically starting weight based heparin nomograms if they see certain inflammatory values.


    Also were running out of sedation and are starting patients on enteral meds to sedate while using intermittent IVP doses of fentanyl and versed to avoid sedation infusions.

  6. #3786
    Twitter is reporting that Telsa is now making (or is having made?) BPAP machines instead of full featured ventilators. How useful is that, if at all?

  7. #3787
    THE THIRST MUTILATOR Nephrology's Avatar
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    Quote Originally Posted by 45dotACP View Post
    I could be mistaken but a buddy in our Adult Surgical Heart Unit tells me we have something like 7 or 8 ECMO circuits running and more than half are COVID-19 patients.

    Unrelated, but a lot of the younger patients throw PEs to the point where some of our intensivists have been empirically starting weight based heparin nomograms if they see certain inflammatory values.


    Also were running out of sedation and are starting patients on enteral meds to sedate while using intermittent IVP doses of fentanyl and versed to avoid sedation infusions.
    Weird. We're not noticing PEs at least as far as I can tell from our team documents. We're definitely seeing cardiomyopathies and arrhythmias esp. b/c HCQ is SOP for anyone with ARDS. Also have seen a lot of people with severe distributive shock that is being attributed to "cytokine storm." Those patients are eligible to enroll in trials for Toculizumab and Sarulimumab.

    Quote Originally Posted by TheRoland View Post
    Twitter is reporting the Telsa is making (or having made?) BPAP machines instead of full featured ventilators. How useful is that, if at all?
    Lol yeah. They bought the BiPAP machines, didn't make them. They've made 0 ventilators AFAIK.

    BiPAP is basically a mask you wear that forces air into your mouth and thus into your lungs. It's less invasive than intubation so it doesn't require sedation or come with the risks of intubation which is nice, but it also can't move nearly the same amount of air in and out of the patient's lungs. It's not being used at our hospital right now, and I believe we're following the national trend.

    We're not using it because

    1. It generates a lot of aerosols - IIRC it is an open ventilation circuit so patient exhaust goes to room air. This is bad because it's actively spreading the virus around the room.

    2. There is a general thought that if these patients require more oxygen than can be delivered by nasal cannula, they're going to require intubation anyway, so may as well skip straight to it.

  8. #3788
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    Quote Originally Posted by TheRoland View Post
    Twitter is reporting that Telsa is now making (or is having made?) BPAP machines instead of full featured ventilators. How useful is that, if at all?
    It's pretty much no help unless the BiPap can be converted to a vent, as a BiPap is an aerosolizing device and will spread the virus further.

    Sent from my moto g(6) using Tapatalk

  9. #3789
    THE THIRST MUTILATOR Nephrology's Avatar
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    Quote Originally Posted by 45dotACP View Post
    It's pretty much no help unless the BiPap can be converted to a vent, as a BiPap is an aerosolizing device and will spread the virus further.

    Sent from my moto g(6) using Tapatalk
    AFAIK most of them can't deliver appropriate TVs and they can't provide PEEP

  10. #3790
    Treatment tracker:
    -------------------------------------------
    https://milkeninstitute.org/covid-19-tracker
    https://milkeninstitute.org/sites/de...er-4-1-WEB.pdf

    "This document contains an aggregation of publicly-available information from validated sources. It is not an endorsement of one approach or treatment over another, but simply a list of all treatments and vaccines currently in development."

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