NYC Doctor Says Ventilators Harm Covid-19 Patients, Treatment Protocols Should Be Changed
Dr. Cameron Kyle-Sidell says that we should stop dialing up the pressure to open people's lungs
April 24, 2020
In a viral video, an ER doctor who works in New York City claims ventilators kill people by pushing too much oxygen into unaffected lungs. According to Dr. Cameron Kyle-Sidell Covid-19 might be about the hemoglobin not being able to transport oxygen, as opposed to the lungs being infected.
Doctor Kyle-Sidell was transferred from ICU to ER after he appealed to the hospital management to change the treatment protocol.
So he went online and issued an appeal to all health workers about this.
"It is time for the major medical societies to back up (or at least address) our bedside observations: a COVID19+ patient presenting to the ER with bilateral infiltrates and a low p/f ratio DOES NOT have the ARDS from the RCTs of the 2000s, and should NOT be treated as if they do," Kyle-Sidell posted on Twitter.
"Please look at and understand the disease porphyria. We collapse just like the people in the videos of those in Wuhan when hit with an abdominal seizure stemming from a subclinical hypoxic state. The basis for porphyria is a genetic issue which causes us not to produce heme properly. Heme binds oxygen to hemoglobin as you know. A vent is the last thing we need. We need oxygen, IV benzos to stop seizing and tachycardia, IV opiates to stop pain. D5 or D10 and proper electrolyte replacement. Possibly sublingual hyoscyamine, an antispasmodic. Some of us talked about how the entire world would experience porphyria attacks once 5G or high EMF exposure reached more people. It came much quicker than we thought. Please consider this information." writes one doctor in response.
A nurse writes: "Dr Kyle-Sidell, I hear your frustration and hope you can persevere. You are amongst our greatest heroes!
I'm a retired RRT and remember many cases of ARDS ventilation. High positive pressure is the enemy of the lung and the circulatory system. Blowing holes in delicate lung tissue leading to pneumothorax or retarding venous return leading decreased cardiac output is never good.
A number of strategies have been used. I see other comments regarding hyperbaric chambers which may be an option to raise blood oxygen without large transient airway pressures. The gas pressure stays elevated. Unfortunately, there are fewer of these devices available than there are ventilators.
High frequency ventilation is another option which uses low pressure but much faster respiratory rates. Some researchers successfully ventilated patients with fistulas communicating airway gas to vacuum chest tubes. It was not common.
My best option for you in extreme cases is "permissive hypoxia/hypercapnia." In this model one does not attempt to normalize oxygen (100 mmHg) or carbon dioxide (40mmHg). One accepts lower oxygen and higher CO2 levels in the blood to allow lower: fraction of inspired oxygen percent, positive end expiratory pressures and peak transient airway pressure. I recall articles from Chest, NEJM and RC Journal that describe this method; I regret I do not have specific references anymore. A lit search should turn these up, however.