I believe we do NOT understand PE pathophysiology. Therefore, we do NOT understand COVID19.

Serotonin rules PE cardiovascular changes.
Serotonin rules COVID19 pathology.

1967 paper:
https://www.sciencedirect.com/science/article/abs/pii/000291496790104X

@iceman_ex @Acute_Pulmo_Med @ThinkingCC @srrezaie @cameronks @gattinon
I believe we do NOT understand PE pathophysiology. Therefore, we do NOT understand COVID19.Serotonin rules PE cardiovascular changes.Serotonin rules COVID19 pathology.1967 paper: https://www.sciencedirect.com/science/article/abs/pii/000291496790104X @iceman_ex @Acute_Pulmo_Med @ThinkingCC @srrezaie @cameronks @gattinon
I believe we do NOT understand PE pathophysiology. Therefore, we do NOT understand COVID19.Serotonin rules PE cardiovascular changes.Serotonin rules COVID19 pathology.1967 paper: https://www.sciencedirect.com/science/article/abs/pii/000291496790104X @iceman_ex @Acute_Pulmo_Med @ThinkingCC @srrezaie @cameronks @gattinon
I believe we do NOT understand PE pathophysiology. Therefore, we do NOT understand COVID19.Serotonin rules PE cardiovascular changes.Serotonin rules COVID19 pathology.1967 paper: https://www.sciencedirect.com/science/article/abs/pii/000291496790104X @iceman_ex @Acute_Pulmo_Med @ThinkingCC @srrezaie @cameronks @gattinon
The absolute most indisputable piece of evidence in COVID19 that implicates serotonin-induced DIFFUSE pulmonary microvascular spasm is provided by @jwmdebacker - there is DIFFUSE spasm of entire microvascular bed of the lung, not just in areas of GGOs. https://twitter.com/i/status/1313139869292662785
Now can serotonin infusion / release in pulm vascular bed lead to "silent" hypoxia? YES!

To hyperpnea (via carotid sinus)? YES!

Why hyperpnea? To compensate for dead-space physiology, to reduce high V/Q mismatch developed due to pulm vasoconstriction

https://pubmed.ncbi.nlm.nih.gov/13435356/ 
Now can serotonin infusion / release in pulm vascular bed lead to "silent" hypoxia? YES!To hyperpnea (via carotid sinus)? YES!Why hyperpnea? To compensate for dead-space physiology, to reduce high V/Q mismatch developed due to pulm vasoconstriction https://pubmed.ncbi.nlm.nih.gov/13435356/ 
Now can serotonin infusion / release in pulm vascular bed lead to "silent" hypoxia? YES!To hyperpnea (via carotid sinus)? YES!Why hyperpnea? To compensate for dead-space physiology, to reduce high V/Q mismatch developed due to pulm vasoconstriction https://pubmed.ncbi.nlm.nih.gov/13435356/ 
Now can serotonin infusion / release in pulm vascular bed lead to "silent" hypoxia? YES!To hyperpnea (via carotid sinus)? YES!Why hyperpnea? To compensate for dead-space physiology, to reduce high V/Q mismatch developed due to pulm vasoconstriction https://pubmed.ncbi.nlm.nih.gov/13435356/ 
Further evidence of such changes due to serotonin
- hypoxia
- reduced compliance
- hyperpnea
- large intrathoracic pressure swings (even after succ) --> "P-SILI" @gattinon?

https://www.sciencedirect.com/science/article/abs/pii/0002870357901898
P-SILI anyone?
Pneumothorax in absence of positive pressure??

Serotonin hyperpnea demonstrated
👇
What happens when you remove platelets in experimental micro-PE (e.g. akin to COVID19)?

Same thing that happens when you treat with heparin.
Same thing that happens when you antagonize serotonin.

Hypoxia resolves.
PVR rise diminishes.

http://pdfs.semanticscholar.org/2c1f/4d08df25ac4083a33a8621f4d04eede4b465.pdf
What happens when you remove platelets in experimental micro-PE (e.g. akin to COVID19)? Same thing that happens when you treat with heparin.Same thing that happens when you antagonize serotonin.Hypoxia resolves.PVR rise diminishes. http://pdfs.semanticscholar.org/2c1f/4d08df25ac4083a33a8621f4d04eede4b465.pdf
What happens when you remove platelets in experimental micro-PE (e.g. akin to COVID19)? Same thing that happens when you treat with heparin.Same thing that happens when you antagonize serotonin.Hypoxia resolves.PVR rise diminishes. http://pdfs.semanticscholar.org/2c1f/4d08df25ac4083a33a8621f4d04eede4b465.pdf
What happens when you remove platelets in experimental micro-PE (e.g. akin to COVID19)? Same thing that happens when you treat with heparin.Same thing that happens when you antagonize serotonin.Hypoxia resolves.PVR rise diminishes. http://pdfs.semanticscholar.org/2c1f/4d08df25ac4083a33a8621f4d04eede4b465.pdf
What happens when you remove platelets in experimental micro-PE (e.g. akin to COVID19)? Same thing that happens when you treat with heparin.Same thing that happens when you antagonize serotonin.Hypoxia resolves.PVR rise diminishes. http://pdfs.semanticscholar.org/2c1f/4d08df25ac4083a33a8621f4d04eede4b465.pdf
Now can SEROTONIN freed up from PLTs in micro-PE induce a 🔥SEVERE intrapulmon VENOUS hypertension, with no increase in large extrapulm veins?

Pulm edema of PE?
👉GGO of COVID19?

Acute alveolar filling due to ⬆️hydrostatic P? All due to PLT serotonin?

https://bit.ly/3qVjCHa 
Now can SEROTONIN freed up from PLTs in micro-PE induce a SEVERE intrapulmon VENOUS hypertension, with no increase in large extrapulm veins?Pulm edema of PE?GGO of COVID19? Acute alveolar filling due to hydrostatic P? All due to PLT serotonin? https://bit.ly/3qVjCHa 
Now can SEROTONIN freed up from PLTs in micro-PE induce a SEVERE intrapulmon VENOUS hypertension, with no increase in large extrapulm veins?Pulm edema of PE?GGO of COVID19? Acute alveolar filling due to hydrostatic P? All due to PLT serotonin? https://bit.ly/3qVjCHa 
Now can SEROTONIN freed up from PLTs in micro-PE induce a SEVERE intrapulmon VENOUS hypertension, with no increase in large extrapulm veins?Pulm edema of PE?GGO of COVID19? Acute alveolar filling due to hydrostatic P? All due to PLT serotonin? https://bit.ly/3qVjCHa 
Now can SEROTONIN freed up from PLTs in micro-PE induce a SEVERE intrapulmon VENOUS hypertension, with no increase in large extrapulm veins?Pulm edema of PE?GGO of COVID19? Acute alveolar filling due to hydrostatic P? All due to PLT serotonin? https://bit.ly/3qVjCHa 
You can follow @farid__jalali.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled:
Those who think consciousness raising & movement building are disconnected, or even a distraction from electoral politics have not paid attention to the history of social change.In this thread, we
Read more
The 2020s will be known as the Remote Work decadeA few predictions of what is likely to emerge[ a thread ] Third Space: Office and Working from Home will
Read more
1/29: Have you ever had a concept explained to you that helps frame complex issues you’ve been wrestling with and opens your eyes to new possibilities? A concept that I
Read more
By continuing to use the site, you are consenting to the use of cookies as explained in our Cookie Policy to improve your experience.