right? So once these patients are eventually intubated in the OR, how are you managing their, like, that must be very tight vent management, right? I mean, I feel like that would be a very tricky situation to be in.

yeah it's reflexively when somebody who's really critically ill we want to i say reflexively we kind of reactively if we're either bagging manually we're gonna squeeze really hard we want to see the oxygenation get better or we're really excited and that's what we naturally want to do because that's our own sympathetic system or we turn on our machine on the ventilator which has pre-standard standard settings And they tend to be higher tidal volumes.

There's a certain amount of end expiratory pressure that's on a ventilator.

That also increases airway pressure.

And like Dr. Efron was saying, that increased airway pressure doesn't help some of these patients.

So really, everything that we normally would do is probably the worst thing we should do in a lot of these patients.

Fortunately, as Dr. Efron said, this is a minority of situations.

So maybe if you could just comment on that a bit.