Friday, May 08, 2020

Blood Thinners and CPAP Machines

Randomized double-blind placebo-controlled (RDBPC) studies are the gold standard when it comes to testing vaccines and medicines. Unfortunately, they take a long time--typically well over a year--to conduct, and the coronavirus' damage to health and the economy doesn't allow leeway to develop RDBPC solutions.

Medical practitioners are now forced to make educated guesses about possible treatments: [bold added]
2013 sleep study resulted in
us getting a CPAP machine
Regardless of the cause, anecdotal evidence of blood clots in COVID-19 patients is prompting many physicians to examine more closely whether a certain subgroup of these patients — those sick enough to be hospitalized — should receive blood thinners as a preventive measure as soon as they’re admitted.

The American Society of Hematology’s recently updated recommendations include the use of low-dose blood thinners for hospitalized COVID-19 patients unless they have a condition that puts them at higher risk of bleeding...

it was New York emergency room doctors who told their West Coast counterparts about the apparent unexpected benefits of keeping patients off ventilators as much as possible...

This is a pivot away from earlier thought, which was that COVID-19 patients who came to the hospital struggling to breathe should be intubated, or placed on a ventilator. But anecdotal evidence from hospitals in New York and Italy shows that patients often do better than expected with less invasive treatments that help them breathe — CPAP machines, which administer oxygen through a mask, and high-flow nasal cannula, where oxygen tubes are inserted into the nostrils.
Blood thinners and CPAP machines are not the gold standard, but anecdotal evidence is still evidence.

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