In some patients, COVID-19 appears to present more like altitude sickness -- prompting warnings that doctors need to pay attention to how the virus has affected the lungs and breathing of each patient they’re treating before deciding on treatment.
April 7, 2020 -- As doctors treat more patients who are severely ill from COVID-19, they’re noticing differences in how their lungs are damaged.
“A whole bunch of these patients really have low oxygen, but their lungs don’t look all that bad,” says Todd Bull, MD, director for the Center of Lungs and Breathing at the University of Colorado School of Medicine, in Aurora. Patients with respiratory failure who can still breathe OK, but have still have very low oxygen, may improve on oxygen alone, or on oxygen delivered through a lower pressure setting on a ventilator.
This problem with the blood vessels is similar to what happens in a condition called high-altitude pulmonary edema, or HAPE, says Bull. In normal breathing, our lungs expand because of negative pressure. A large thin muscle at the bottom of the lungs, called the diaphragm, pulls down and our lungs expand to fill the increased space. But ventilators work by forcing air into the lungs, which is positive pressure, like what happens when you blow up a balloon. These machines can help people whose lungs have become too weak to work, but they can also cause damage because they force the lung to work in a way it wasn’t designed to.
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