By Billy Hammond (Copyright AELS)

May 4, 2020

I saw a patient on a ventilator in an ICU ward on TV who was positioned face down. If I hadn’t taken the course in mechanical ventilation from Harvard Medical School, I would have wondered what the reason was for putting a patient in what would seem to be such an unusual position.

The weights of the heart, chest wall, abdominal contents, and the lungs themselves exert pressure on the lungs and compress them. This leads to atelectasis and derecruitment. Proning the patient helps maximize the V/Q (ventilation and perfusion ratio) and prevents atelectasis, which is a big problem in Covid-19 and ARDS patients.

Thus, the team in the Japanese hospital was taking advantage of the latest research in pulmonary care for Covid-19. The scene impressed me and made me aware of all the efforts being made by Japanese medical staff (proning requires a team of at least 5 members and the patient usually needs to be turned every 12-16 hours and is continued for as long as the PaO2/FiO2 ratio remains under 150).

COVID-19患者腹臥位

テレビで関東のICU内の人工呼吸器に繋いでいた新型コロナウイルス患者が映っていた。患者さんは

腹臥位(うつぶせ)に寝かせていた。先日終えた人工呼吸器のコースを受けていなかったら、『なぜそのような変わった方向に寝かしているか』ときっと思っただろう。

心臓、胸壁、腹部内容、肺の重さが肺を圧迫して圧縮する。これにより、無気肺になる。腹臥位によるとその圧迫を和らげ、V/Q(換気血流比)を最大化し、Covid-19ARDS(急性呼吸促迫症候群) 患者に問題となる無気肺を防ぐ。

それを観たとき、『さすが、日本の医療は凄い!』と思った。腹臥位の人工呼吸器使用には少なくとも5人のチームが必要し、1216時間毎に向きを替えなければならない。PaO2/FiO2 150以下である限り何日間も続ける。大変な治療法だ。

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English novels by Billy Hammond published by AELS

(AELS出版英語書籍リスト)

 

I. Majoh Gakuin and Hikari Juku – Japanese Witch Schools Trilogy

1. Majoh Gakuin & Hikari Juku – Japanese Witch Schools

2. Lost Witch (The second book)

3. Fate & Magic (The final book in the trilogy)

II. Brindle – Scryer Extraordinaire Trilogy

1. Brindle – Scryer Extraordinaire

2. Brindle – Scryer Extraordinaire – Returns

3. Brindle – Scryer Extraordinaire – Challenges (The final book in the trilogy)

III. Fantasy fiction set in Japan

1. 21st Century Ninja

2. Regressed

3. Japanese Woman

IV. Fantasy fiction set outside of Japan

1. Dimension Jumpers

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