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CPAP use for Coronavirus mitigation & severe pneumonia
RE: CPAP use for Coronavirus mitigation & severe pneumonia
So far the SuperSleeper seven point plan seems the most viable ... not an expert here, but my two cents.

I am on ASV with oxygen concentrator. I use a bleed-in line. I don't always have my AHI controlled well when I have asthma or any lung infection. My doctor does not try to increase my pressure at those times (maybe because I'm already tolerating as much pressure as I can), but he does increase my oxygen from 3 lpm to 4 (or higher if need be) for a couple of weeks or until my AHI comes down for awhile.

With severe pneumonia, this might not help, but it couldn't hurt either. I see used oxygen concentrators for sale quite regularly on Craig's list and ebay. The big blue box kind go to 5 lpm. The bleed in line and adaptor are super cheap on Amazon. Personally, if I wasn't already on oxygen, I would consider adding oxygen to the 7 point plan.

Also, though this is not technically part of what you asked for here, but I would consider any measure to reduce inflammation in the lungs, possibly using adaptogens. Can anyone add any knowledge about what might be useful in this regard?  I have had good luck with CBD and CBD/THC jellies, but there are probably other OTC counter things that might help.

Also, are the "breathing exercizer" devices of any use in increasing oxygen saturation with pneumonia?

Don't shoot me if you don't like my additions here....just brainstorming.






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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Brainstorming is exactly what we need.  Good ideas!

I would agree that O2 would be a great addition.  I simply didn't include it in the 7-point plan because most people don't have access to an O2 generator or O2 supply of any type at home.

You never know what will come of an idea, and an idea not written down will help no one.   like
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Has anyone tested to see how much of a pressure increase can be had by using two machines in series?  If not, and it is worth knowing, I have two machines so I can try to measure.
RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-20-2020, 09:05 PM)tedvpap Wrote: Has anyone tested to see how much of a pressure increase can be had by using two machines in series?  If not, and it is worth knowing, I have two machines so I can try to measure.


Good thought.  Not sure.  I would think one would need a manometer to measure the final output pressure.

They're available for sale on many websites.
SuperSleeper
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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
(03-20-2020, 09:10 PM)SuperSleeper Wrote:
(03-20-2020, 09:05 PM)tedvpap Wrote: Has anyone tested to see how much of a pressure increase can be had by using two machines in series?  If not, and it is worth knowing, I have two machines so I can try to measure.


Good thought.  Not sure.  I would think one would need a manometer to measure the final output pressure.

They're available for sale on many websites.

I use water in the tube height to measure the pressure.  I have done this before when I thought a gifted machine was not performing properly.  It was spot on.  
Since I am now curious, I'll give it a try tomorrow.  In addition, my friend would benefit from a higher pressure (>20).  This may give him an opportunity to try it out.

Edit: I think the pressure control system will likely defeat the added boost but I'll try it anyway.
RE: CPAP use for Coronavirus mitigation & severe pneumonia
I wonder if there is some essential oil that would be both safe and effective to use with the CPAP?
RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hi Folks!
Nice email today.  I'm way ahead of you SS.  I was thinking about this last week.

I picked up my 5 year re-do prescription so I can get my second machine (paid for by insurance).  I intend to save it as a "poor-man's ventilator" for my parents.

From what I've read RTs will be in critical supply at medical facilities.  

My thought: O2.  Although I would love to pre-order and store it, I cannot without a script.  Even so, I am unsure of how to set up and run an 02 line, doseage, etc.  Are there complications with 02 toxicity or autonomic suppression?

IF things go to hell, and I need to add O2 how do I know what to do to get it right?






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RE: CPAP use for Coronavirus mitigation & severe pneumonia
For O2 flow, there are Liter per Minute flow meters, mechanical, easy to use, but moderate expensive. The problem I've found is that a tank of O2, say an 80cf welding tank, has very limited capacity for full time use. It is still O2, just not as pure, and can have particulates, so adequate filtration is needed before it gets to a mask (we are talking last ditch emergency battle field style care, hypothetical, right?).

As for flow rates per person, my gut feel is using an Oximeter is almost a requirement. Add O2 to your mask sufficient to hit >90% saturation (per some of the excellent articles posted earlier in this thread). Flows of 5 to 15 LPM were mentioned, but that seems rather high compared to at-rest respiration volumes.

Anyway, O2 generation at home seems almost a necessity during the discussion.
RE: CPAP use for Coronavirus mitigation & severe pneumonia
I found this article interesting and haven't seen it posted already, unless I missed it.

NIV for Pneumonia

"Conclusions?  If you need to start pressors, or have new onset renal insufficiency, you may want to skip NIV and reach for the intubation kit first.  Otherwise, with 40-75% success rate of NIV, and without an adverse outcome for delayed intubation in pneumonia patients, it seems reasonable for the patient to first have a trial of non-invasive ventilation."
RE: CPAP use for Coronavirus mitigation & severe pneumonia
From the WHO's interim guide for Acute Respiratory Distress Syndome, p. 4, which can be found here:

https://www.who.int/publications-detail/...-suspected

Onset: within 1 week of a known clinical insult or new or worsening respiratory symptoms.

Chest imaging (radiograph, CT scan, or lung ultrasound): bilateral opacities, not fully explained by volume overload, lobar or lung
collapse, or nodules.

Origin of pulmonary infiltrates: respiratory failure not fully explained by cardiac failure or fluid overload. Need objective assessment
(e.g. echocardiography) to exclude hydrostatic cause of infiltrates/oedema if no risk factor present.

Oxygenation impairment in adults (17, 19):

 Mild ARDS: 200 mmHg < PaO2/FiO2 ≤ 300 mmHg (with PEEP or CPAP ≥ 5 cmH2O, or non-ventilated)
 Moderate ARDS: 100 mmHg < PaO2/FiO2 ≤ 200 mmHg (with PEEP ≥ 5 cmH2O, or non-ventilated)
 Severe ARDS: PaO2/FiO2 ≤ 100 mmHg (with PEEP ≥ 5 cmH2O, or non-ventilated)
 When PaO2 is not available, SpO2/FiO2 ≤ 315 suggests ARDS (including in non-ventilated patients).






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