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[COVID-19] CPAP use for Coronavirus mitigation & severe pneumonia
RE: CPAP use for Coronavirus mitigation & severe pneumonia
How is well water for bacteria?? Viruses? Does leave hard water deposits on tank of course. Vinegar gets em off though.. of late, ive left tank dry. Fewer mouth bugs since going dry. Tongue gets real dry sometimes.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Here is the reply from my pulmonologist. I'm not sure he understand the "worst case scenario" premise I put to him, and that, at least in my case, aerosolization is a moot point. As someone put in this thread, by the time I go on CPAP for covid, my wife will have been exposed 5 days ago. Nevertheless, here is his reply:

What you describe about aerosolizing the virus and making it more likely to cause infection in others around you is true. We are trying to avoid using CPAP or BiPAP in all coronavirus patient's. If he starts to develop fever, cough, or dyspnea I would consider holding your therapy or sleeping in separate rooms.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
I heartily agree to "plan for the worst and hope for the best". About 2 months ago I upgraded from Airsense 10 CPAP to Airsense 10 AUTO set. I was amazed that it auto-adjusts with every breath, in my case from 5-10 cmH2O. During the night, it can go from 5 to 8 down to 6, up to 10. Thanks to the apneaboard software (plus I had to add my own SD card), I get beautiful plots not available from Resmed online ot the clinician software. Back to the point: when allergy season hit recently and I stuff up, the pressure looks to be higher than on nice days. I assume-hope that is true with the flu. A retired relative DID have flu earlier this year, probably not COV, and the Airsense 10 did fine. I suggested bumping her humidity UP a little to keep her lungs moist and help to cough up gunk. It seems to have helped. Turned the heated hose down a little when there was fever. Don't know if that is the medical thing to do,i just seemed reasonable.
Lastly, my doctor once warned ME not to set my pressure much above her set point (10 back then) because, she said, too high a pressure will cause CNS apnea, where brain is causing it. I saw people online saying a 15 setting, double the doc set, was okay. She said not. Now, the Autoset makes it right every breath.
BTW, my Medicare supplier, Lincare, took 8 weeks to get it to me, counting from the day the doc sent them the order. Like all resmed gear, retail price is obscene (IMHO)
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-25-2020, 07:18 PM)zxccxzasd2 Wrote: I heartily agree to "plan for the worst and hope for the best". About 2 months ago I upgraded from Airsense 10 CPAP to Airsense 10 AUTO set. I was amazed that it auto-adjusts with every breath, in my case from 5-10 cmH2O.

I had my AirSense 10 AutoSet programmed for 5-15. I had to change it to 7-15 because the auto start/stop feature doesn't work reliably under 7. I got so accustomed to auto start/stop with my older machines that I really missed it when it didn't work.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
If I can help, then please let me know. I am the regional manager of a sleep apnea/home oxygen company in BC, Canada (RRT FCSRT. PSGT). I deal specifically with IVAPS, CPAP, APAP, BiPAP, AVS, and home ventilation, as well as home oxygen provider under the HOP of British Columbia. Been doing it for over 25 years, in 3 different countries, as well as a plentiful enough experience in critical care. Thanx!
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Im sorry I don't have any practical advice but I did mention this (use of asv, cpap)to someone I know (intensive care doctor) and he thought it was a very good idea (being in the profession, he couldnt say much more..sorry).


One thing I have noticed reading this forum is that there are a lot of extremely knowledgeable members that will trouble-shoot and offer solutions. Thank you so much!!

take care everyone
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Thought of this thread when I read about the following in the news today:


VESper™ is a unique ventilator expansion device that allows a single ventilator to support up to four patients during times of acute equipment shortages such as the current COVID-19 pandemic.
Produced using 3D printing technology, the device is developed with material already in use for medical devices and produced at minimal cost.
The device: 
  • meets international quality standards (ISO); 
  • can be easily produced; 
  • allows for appropriate filtering of bacteria and viruses in the ventilator tubing;  
  • is strong and impact resistant; and  
  • does not impact the care of other patients connected to the same machine.
    Is it FDA approved? Prisma Health has received emergency use authorization from the U.S. Food and Drug Administration (FDA) for VESper™. Emergency use authorization can offer critical care patients access to a medical device that has not gone through normal FDA approval; this is used when no comparable or satisfactory alternative options are available.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-25-2020, 06:53 PM)Westerj Wrote: How is well water for bacteria?? Viruses? Does leave hard water deposits on tank of course. Vinegar gets em off though.. of late, ive left tank dry. Fewer mouth bugs since going dry. Tongue gets real dry sometimes.

Well water will be variable with respect  to bacterial content. The greatest  risk is for enteric pathogens due to fecal contamination from improperly sealed wells, improperly functioning septic systems, drainage from animal waste, etc. This is a risk for shallow wells but probably not for deep wells. Bacteria that cause respiratory infections are unlikely to be found in well water. Pathogenic bacteria are unlikely to grow in well water because of lack of nutrients. Viruses, especially coronavirus are very unlikely. In most cases the risk of chemical contamination is worse than microbial.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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RE: CPAP use for Coronavirus mitigation & severe pneumonia
I was thinking about this very issue when I got the notification of this thread. I think a system that can create pressure in the ways CPAP/BiPAP can should be able to provide some level of symptomatic relief but not necessarily out of the box for severe cases, if at all. But these are things that need to be addressed by those in the industry and med professionals of all kind, especially those who design ventilators.

Here are other things I'm thinking about:

Is there a governor on these things to prevent over pressuring?  We all know that is a qualified yes. It might be software or the way the machine is
built, which might mean they can't do the job out in the wild if we already have one. Doesn't mean they can't have some amelioratory impact now, but I can't say for sure. 

Can they be refitted in the factory, if the machines are too weak? If situation calls for it and manufacturers work with med engineers, maybe... that's my feeling. Nothing isn't made that can't be fiddled with given resources and know-how. Might even be a way to retrofit. Definitely need something soon, so better a quick fix to get us to the next fix than none at all.

Pneumonic patients may require extraordinary steps that are not "in the books" like getting a chest tube for drainage or having some kind of ad hoc system where it's like dialysis for respiration. How does that look? What are contraindications for infection or likelihood of lung collapse? Not a doctor, so not sure what might be done.

Is there a way to tie these things together or ventilators together for monitoring only but provide a secondary, central remote control independently for each system like a mobile command center? Alleviates need to directly interact and reduces need for extra hands to some extent.

Getting hotels and motels near infection hot zones to become expanded hospitals. Why has no one moved faster on this? (Will be the question heard over and over during this crisis.)

Got more but sure more of use have been thinking the same stuff. 

Thanks for being on the same page with this all.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-25-2020, 06:35 PM)tesaro Wrote: I thought of using the Cpap as a ventilator, because it makes sense to me that if you increase the pressure above what one needs normally, it will force air into the lungs, which seems logical would increase one's oxygen. I contacted my pulmonary specialist but have yet to receive a reply! I hope someone has a good answer. Thank you! Teresa


 
Hi,
 
There is plenty of demonstration that a CPAP is operational in SRAS diseases (when lungs are not so damaged that a specific ventilation machine should be employed). I believe ther is no point about this: this thread contains at least 2 posts with references you can use ton convince you with that.
 
BUT: never forget that APNEABOARD is NOT intended for medical advices and you should always have medical order to use a medical device. Modifying biophysics condition is always to be considered with risk – benefice balance.
 
This thread is intended to be used in “last chance” condition if there is NO OTHER WAY to save somebody… Not to replace medical standard…
 
IMHO, a specialist in “normal condition” will say “no this is forbidden by: AMM (in france), FDA (in USA), ...”… 
 
The best help we could have now would be to have a specialist with us in APNEABOARD… ?

 
FJD
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