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CPAP use for Coronavirus mitigation & severe pneumonia
RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hi, all
 
_Congrats for this thread!
 
_ I have been following this thread for while; great points..... difficult perfect, even palliative solutions! 
 
_ I am not sure whether I have missed something important. However, particularly, luckily, I don't have concerns on aerolisation of virus at home; I have a backup small/office/apartment in my building, so that, just in case, I am planning to use it for some relative or myself, if necesseary (hope, not);
 
_ Maybe you guys could build a separated, isolated room on your backyard; camping style, and so forth?.....I know, different weather conditions, etc, may prevent ........
 
_ I saw Resmed issues, above: “Noninvasive ventilator specialist Resmed is also cautious about potential disease spread with its products, but it argued that these mask or mouthpiece-based devices may be no worse than a coughing or sneezing person, distributing droplets rather than the more tiny and long-lasting airborne aerosols, within only about one meter. When it comes to CPAP and BiPAP, Resmed expects that BiPAP might prove more useful for COVID-19 patients. Our Aircurve 10 bilevel devices, which look like our CPAP devices, can provide support to some COVID-19 patients,” the company said in a COVID-19-related product Q&A.”
 
_ What I am studying now is the Bilevel and oxygen proper set ups. Any consensus, general guidance thus far? 
 
good luck
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature









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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-29-2020, 03:03 PM)mper6794 Wrote: _ Maybe you guys could build a separated, isolated room on your backyard; camping style, and so forth?.....I know, different weather conditions, etc, may prevent ..


This is something I hadn't thought of.  Good idea.  Get a small camping tent, seal the side screens as best you can with duct tape or other methods, then set up a fan to pull air from the main entrance  across the patient's body, over their head and out a screened opening in the back of the tent, away from the primary opening where a care-giver might come in, and the care-giver would have to wear PPE.  Not perfect, but better than no separation from others in the house and venting virus particles into the house.  Could set up garden hose, bowl for washing, and a "Luggable Loo" for the patient to utilize for temporary bathroom use.

Heck, if MASH units can do full surgeries in tents, why couldn't we do something similar for a sick room?

like
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
I'm convinced that Sleeprider has brought up a valid scenario if/when there aren't any real ventilators available.

Several years ago, my CPAP helped me heal and re-inflate my left lung following a medical malpractice incident during kidney surgery.  Post-Op, they'd let me go for two weeks with the collapsed lung, and they kept denying there was an issue.  "You're over 50 and this is what recovery is like."

I finally went to another "brand" of hospital, who diagnosed the damage when they took a chest Xray.  The initial recovery procedure was when they removed the 1.5 qt of fluid in my plural cavity, that had been forcing my lung up under my shoulder. 

My nightly CPAP "treatment" is what actually re-inflated my lung and that little machine has been my lifesaver ever since.  

If the time comes when the hospitals are overcrowded to the point of putting patients in tents, I'd be in a better situation at home with something that can help me.  I'm glad that Sleeprider has started me thinking about this.
RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hey all i hope that you and yours are indoors and safe!

So as someone who has various pre existing conditions and became aware just over a week ago that things would get to the point quickly that i would be classed as a person unsuitable for intensive treatment at hospital and would be given at best oxygen, probably as palliative care.......i got to a lot of reading.

My first thought was to just rip open my airsense 10 and rig up some electrics to take over control so i could force the machine to allow me to get more of a respirator action given the stock machine only gives a 3cm drop in EPAP at most..........But then i read that the thing that kills is not the the ability to breathe (i.e. the in out breath i was hoping to force the machine to do) but that the virus makes your lungs fill with a sticky mucus and as they fill the remaining alveoli are at risk of bursting if i was to proceed with a rudimentary ventilator.

So my take away at this point was it was not a solution and that the key was the PEEP valve allows for back pressure to keep the lungs inflated slightly on exhale to allow the flow of mucus.........drugs to dry it up and this back pressure is what is likely going to save me.  I dont have access to drugs so i decided my next option was to make a ventilator from an AMBU bag (resusitator valve bag) with suplimental oxygen from a cheap oxygen concentrator and automated by either a window wiper motor or more likely parts from a 3d printer (mechanical parts). This is to be made this week......

So my next worry was the volatisation of the virus spreading from me to the rest of the house, or even the other way round and hospital ventilators filter the exhaust gasses so that it is not volatised in the air.......and i see the issue with the volatisation being that if someone is there to care for you, their PPE is ineffective as they do not filter volatised particles effectively.........so this was another reason why i was straying away from the CPAP as being my solution, unless i could filter the vent on my cpap mask.

Then i read a story about italy using decathalon full face snorkle mask as respirator masks and i knew i had to get one:

https://www.isinnova.it/easy-covid19-eng/

my AMBU bag has a PEEP valve and i managed to get hold of an inline filter which can be used to filter the exhaust.....this way as i do not have a BiLevel or ASV machine i can use the AMBU bag ventilator if absolutely necessary and can use this mask with my existing CPAP to help not get that bad in the first instance or to recuperate if i survive the worst of it on the AMBU bag.

I have a 3d printer so can make an attachment.......those who dont could easily use a polymorph mouldable thermoplastic to fashion what was needed around filters etc.......

Our London hospitals have today said that they would be witholding treatment from the likes of me and it will only be a week before that is my hospital.........so i think i need to crack on with preparing.

Take it easy,

Geo.






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RE: CPAP use for Coronavirus mitigation & severe pneumonia
I have another thought on the volitisation as i remember now about have read in the thread about the logic of the virus already being in the house........and my thought is along the line of viral loading. Surely if i become infected the forced air into and around my infected lungs and back out into the room will be laden with virus and pose a far greater risk to the household than their chances of getting it off the virus load in the house.

And the volatisation reduces the effectiveness of any PPE you may be using.........And rather than the virus getting into my daughter via her dirty hand to her mouth, where she stands a chance maybe of not getting extreemly sick vs the virus into her lungs and she does.

Of course i may be wrong but thats my current understanding.......

Take it easy,

Geo.
RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-29-2020, 01:44 PM)Muddpa Wrote: WOW, I read the post and I have no answer, except to pray and cross my fingers.  Please everyone try to stay safe and healthy.

(03-29-2020, 07:36 PM)Geologeek Wrote: Hey all i hope that you and yours are indoors and safe!

So as someone who has various pre existing conditions and became aware just over a week ago that things would get to the point quickly that i would be classed as a person unsuitable for intensive treatment at hospital and would be given at best oxygen, probably as palliative care.......i got to a lot of reading.

My first thought was to just rip open my airsense 10 and rig up some electrics to take over control so i could force the machine to allow me to get more of a respirator action given the stock machine only gives a 3cm drop in EPAP at most..........But then i read that the thing that kills is not the the ability to breathe (i.e. the in out breath i was hoping to force the machine to do) but that the virus makes your lungs fill with a sticky mucus and as they fill the remaining alveoli are at risk of bursting if i was to proceed with a rudimentary ventilator.
Geo,
You may want to also consider a mucus-mobilization device like the "Lung Flute" or the acapella Vibratory PEP Therapy System from Smith Medical. There are a number of YouTube videos showing it in use and it may be of some value to loosen and mobilize the mucus from the lower lung to the upper lung where it can be coughed out. The devices are cheap and readily available. 
Like you, I am ultra-high risk with multiple underlying conditions and put this in my backup kit along with expectorant (without the cough suppressant). 
Be well.
Steve
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
RE: CPAP use for Coronavirus mitigation & severe pneumonia
... and thus the need for negative room pressure or a tent outside.... somewhere to separate the patient from the rest of the household.
SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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
(03-29-2020, 08:14 PM)SuperSleeper Wrote: ... and thus the need for negative room pressure or a tent outside.... somewhere to separate the patient from the rest of the household.

Indeed! 

And laterally thinking it might also be worth avoiding people who vape as that cloud of smoke is just like being spat in the face......
RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-29-2020, 08:14 PM)srlevine1 Wrote: Geo,
You may want to also consider a mucus-mobilization device like the "Lung Flute" or the acapella Vibratory PEP Therapy System from Smith Medical. There are a number of YouTube videos showing it in use and it may be of some value to loosen and mobilize the mucus from the lower lung to the upper lung where it can be coughed out. The devices are cheap and readily available. 
Like you, I am ultra-high risk with multiple underlying conditions and put this in my backup kit along with expectorant (without the cough suppressant). 
Be well.
Steve

I had considered the "lung flute" having read about it towards the begining of this thread.........but they were selling for silly money and decided the peep valve on the AMBU bag would do 

Along with the prone positioning which has been mentioned in this thread a few times and i know from someone working on the frontline that this is a technique that is very beneficial

i meant to add more to my post but keep losing my train of thought.....

If anyone is interested in a patients guide to postural drainage from the NHS have a look:

https://royalpapworth.nhs.uk/application...ge_vs4.pdf
RE: CPAP use for Coronavirus mitigation & severe pneumonia
MIT is supposed to publish their modified bag ventilator design soon, but it hasn't happened yet AFIK.

https://www.extremetech.com/extreme/3082...-treatment

I saw this post (obviously not a reliable reference on my part) in response, which while not proof does make me want to know more:

"this machine is just a robotic bag valve mask. There's no ability to have it make any changes to increased resistance from the patient, so if they're coughing or worsening they could get a pneumothorax and damage their lungs from a machine like this. With that being said, this is perfect for surgery rooms and emergency rooms, just not for sustained ventilated patient care...this setup isn't good for patients with coronavirus. Good for surgery...short term ER stuff...but not a long term solution at all. I'd feel very worried about having a patient on something like this for more than a couple of sedated hours."

Is that why you are looking to incorporate a PEEP valve?






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