CPAP use for Coronavirus mitigation & severe pneumonia - Printable Version +- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums) +-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area) +--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum) +--- Thread: CPAP use for Coronavirus mitigation & severe pneumonia (/Thread-CPAP-use-for-Coronavirus-mitigation-severe-pneumonia) |
RE: CPAP use for Coronavirus mitigation & severe pneumonia - lars101 - 03-27-2020 Here is a quote from an article in The Atlantic that was posted on their website 27 March 2020. It was written by an Emergency Room medical doctor in New York City. "Earlier in the month, we were told that positive-pressure oxygen masks, such as CPAP machines, were risky, as they would aerosolize the virus, increasing health-care workers’ risk of getting infected. But in recent days, running dangerously low on ventilators, we have attempted using CPAP machines to stave off the need for medically induced comas." Because this is my first post to this site I am not allowed to provide the link to the article. If you are interested in reading the article perhaps you can google its title, A New York Doctor's Warning. RE: CPAP use for Coronavirus mitigation & severe pneumonia - srlevine1 - 03-27-2020 Nothing new in The Atlantic article except the anecdotal observations of a "resident" being published in a media outlet with a penchant for politicizing the current emergency and attacking the current administration. The risks are well known and controllable. Not so much in a home setting where additional concern may be warranted. Since I use a nasal mask, I am not prevented from coughing or sneezing independently of the exhalation airflow from my mask. As for following New York's lead, I think not. Their governor was warned of a pandemic after SARS and H1N1 and did little or nothing to address the issue at the state level. Now he is excoriating the Administration demanding more -- more money, 30,000 ventilators, and other federal assistance. Here in California, we are finding that the State did not fund the maintenance of an existing emergency stockpile and multiple thousand-bed portable hospitals -- which would have made a major difference, especially for containing the spread of the virus among the mobile homeless population who are already in ill-health, addicted, live in close proximity, and in unsanitary conditions. We are learning -- or should I say re-learning -- what we should have already known. Quote:Airborne Precautions. Quote:Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review RE: CPAP use for Coronavirus mitigation & severe pneumonia - trailrider - 03-28-2020 Hi Lars, Welcome to the Board! You are probably looking for info for a loved one since your info is generic. Thanks for that info about The Atlantic. There has been huge change in treatment posture in even a few days as the medical staff get overrun by a tsunami of patients. What was seemed horridly unprofessional last week is now survival mode (Pampers as masks, garbage bags as disposable gowns, etc) I think a mental shift will happen, within a few days or a week. The wards of ventilator patients will be deemed to already be contaminated, so f-it on keeping the COVID-19 out of the area. At that point PAPs that aerosolize into the room will be accepted. It's not the disease that kills per se, its the ARDS and pneumonia. The protocol will be on keeping the staff alive, which means contagion suits for them. Ignore any political commentary here. Normally it does not happen. Make a shopping mask for you and your loved ones, wash hands, stay home, take care! RE: CPAP use for Coronavirus mitigation & severe pneumonia - Cpapian - 03-28-2020 Here is one guys invention. A retired respiratory therapist from London Ontario. I took a quick look at it. He has three speeds, high, medium and low. Just like the bicycle I had in grade school. I think it is too simple, at least compared to us using our XPAPs, but someone with greater technical knowledge may see potential there. https://www.cbc.ca/news/canada/london/pandemic-ventilator-design-covid19-1.5511412 https://open-source-covid-19-ventilator-canada.mn.co/ RE: CPAP use for Coronavirus mitigation & severe pneumonia - DeepBreathing - 03-28-2020 Cpapian, that device is for hospital use, where the patient is intubated. Like all such ventilators it requires full time qualified nursing care. The website is very clear - this device is for hospitals, not at-home care or DIY. So if you have a hospital short on equipment this might help. For those of us looking for a home-care alternative, this is not it. RE: CPAP use for Coronavirus mitigation & severe pneumonia - 2SleepBetta - 03-28-2020 Others here have touched on matters I have been mulling over and been seeking info for, info pertinent to the use of copper or ozone to disinfect xPAP mask exhaust. Other similar posts can be found by searching the word "copper" in a post; limit the search to, say, threads with 340 posts. Hits, for example, on posts by Crowtor, WMMack (?WMMMack), Stephen N (I think) and Dan451 will come up--members who've also touched on exhaust scrubbers I 've given some thought to. Bubbling mask exhaust through a liquid scrubber may have more merit than anything below. You may wish to just go to the links directly, if the ideas employing copper surfaces and ozone info are familiar and you want more info on copper and ozone use. The negative pressure tube-tent approach in the ending paragraph appeals most to me: simple, easy, things available from hardware, builder, painter stores, if not on hand. I'd prefer an axial fan with a housing to move the air from either outside a window, baffled to prevent backflow into the room, or have it mounted inside tube opening just down airstream from the bed.. Some points. 1. I started looking at copper after seeing mention of it in this thread but was deterred by one of the links below that indicated too much time of contact was required. Days later I looked farther an hour ago and found work by Keevil and Warnes (MDs, I think) indicating much shorter times. The "slow and fast articles" are linked below. Like one member, I had envisoned a scrubber that was packed with the copper scouring pads that are available in food markets, those being packed into a piece of PVC appropriately (air resistance, copper-bypassing issues satisfied, necessarily). Chem engineer/physicist/other such person, please weigh in if ideas here are a dead end; don't lie there ROTFLYAO . Copper is too slow?: https://www.sunjournal.com/2020/02/28/does-copper-kill-a-cold-virus/ Copper might be fast enough with artful design, though expensive (long baffled path, relatively large cross section for low resistance, slow passage): https://www.infectioncontroltoday.com/antibiotics-antimicrobials/using-copper-prevent-spread-respiratory-viruses 2. Ozone kill time and concentration was considered at the following link. Again, lots of time and concentration issues. If a UV bug-zapper tube-kind of idea is in the realm, then … but you have the ozone to be exhausted outside the inhabited space. https://www.ozonetech.com/sites/default/files2/pdf/Ozone_disinfection_of_SARS_Contaminated_Areas.pdf 3. So why not--as others have mentioned in one way or another above a) tent the patient, have the xPAP blower outside the tent, the xPAP hose go through the tent wall to the mask and a duct--I can't think of the name for ducting I have in mind, but it is similar to the flexible tubing used to exhaust hot moist clothes dryer air to the outside. True, that has patients eyes and lips in air contaminated by exhalation. OR b) fashion a large funnel that captures mask exhaust with near zero back pressure and enlarges to enclose and be sealed around the perimeter of a large enough area HEPA filter (assuming effectiveness, which I don't know and may have already been addressed in this thread). OR c) just run a tube, lightweight and sealed at the mask, to a window? 4. It seems 3c above would be easiest to do at home and make access to the patient easiest. A box fan could be rigged just outside the windows to draw air out of the living space (negative pressure) and, possibly to draw exhaust out of the tube/box-channel conveyance. ……………. BUT a tube tent like I carried and sometimes used in Sierra Nevada mountain rains could be made large enough for the bed; have one open end funneled down to seal to a tube extending to a window. Have a fan at the window or at the small other end of the spout near patient). Fan draws clean room air inside the tent and pushes it out the window along with mask exhaust. (This just came to mind and I like it best: simple, cheap, easy. Just a large funnel with a bed in the big end (in effect) similar to those used to put transmission oil in cars. The order of parts from the smaller spout tip outside: an exhaust port opening that penetrates a window baffle, the long funnel spout, the fan (if not at window), the head of bed (or foot), the patient, a head-height-diameter funnel opening out into room. Maybe one of these flaky ideas will help someone else's mind click on THE solution for home use. 2SB RE: CPAP use for Coronavirus mitigation & severe pneumonia - Chalkie - 03-28-2020 OK, I have read through this thread as best I can. Please forgive me if I have missed something. It seems that with my machine the drill is as follows: Ensure 8-12 cm pressure support. I am now at 17-8. BiPAP is essentially a ventilator. Use it 24/7 if need be to aid breathing. May help other family members with breathing issues during this pandemic. Is that the size of it? Do I need to up the pressures or not ? RE: CPAP use for Coronavirus mitigation & severe pneumonia - 3rdMarDiv - 03-28-2020 This article is also speaking toward some other comments I have read on this topic. https://www.npr.org/sections/health-shots/2020/03/27/822211604/cpap-machines-were-seen-as-ventilator-alternatives-but-could-spread-covid-19 Personally, when push comes to shove, I will be trying to use my machine as a ventilator. It looks like, however, that I now need to look into working on a way to filtrate the expelled air. I don't want to be aerosolizing Germs. I wondering if anyone at the CPAP companies are looking into this potential problem. Even if you are asymptomatic you could be super spreading the problem throughout your living environment. One of the responses I found in the social media site along with this article was: I am a respiratory therapist. Our hospital has a back up plan to use bipap machines as ventilators, not with the mask but with an endotracheal tube. This is our last resort and we are close to using them and other hospitals near us are using them because we are out of traditional ventilators. The problem is they have limitations as to the scope of use, they do not allow for advanced technique and specialized settings that we are finding the covid patients require. But we will do whatever we can to save our patients. PS: Hoping this is an acceptable link and doesn't violate hyper link posting rules... RE: CPAP use for Coronavirus mitigation & severe pneumonia - Sleeprider - 03-28-2020 Very good article here that came out from NPR yesterday CPAP Machines Were Seen As Ventilator Alternatives, But Could Spread COVID-19 Quote:How CPAPs spread the coronavirus RE: CPAP use for Coronavirus mitigation & severe pneumonia - 3rdMarDiv - 03-28-2020 Great info SR, thanks. There again, I am looking at all this as a possible alternative where there is no other alternative. No place to go, SpO2 falling, etc. The above NPR article speaks about stopping using CPAP if symptoms appear or you test positive. So, where to go from here? In the NPR article the prospect of a "Sick Room" was brought up. Luckily I have a second floor guest room with full bath, so that is available. I guess that if you feel ill at all you would stop CPAP, if you can, for a couple days and get tested. If you are positive stop CPAP and monitor your vitals. If necessary start CPAP therapy in a sick room...? You know, even if this were only looked at from from a cold or flu spreading issue, you would think that someone would have came up with a CPAP sick filtration mask or mask disease filtrating attachment. Thanks again, I'm back to the drawing board... |