UPDATE:
I am in no way, shape or form suggesting a CPAP is as good as a ventilator. Nor am I suggesting to do this in place of speaking with a physician. Both physicians of the friends to whom I loaned my older CPAP machines thought it was a good idea but to to to ER if they still felt short of breath. I should have stated that initially.
I have been reading about the shortages of ventilators and how critical they are to treating severe COVID-19 cases. I have also seen mention in articles that some hospitals are resorting to using CPAP machines when ventilators are not available.
I have an idea which might help. I have to explain a bit.
“There are things we can do like using anesthesia machines as ventilators.” They can also repurpose travel ventilators to be more permanent, as well as rigging BiPAP and CPAP breathing machines to be used differently than they normally would be.
… patients with moderate respiratory failure, that over time deteriorate to saturate ICUs first, then vents, then CPAP hoods, then even O2.
What is a CPAP, sleep apnea and how do they work?
CPAP (Continuous Positive Airway Pressure), APAP (Auto titrating continuous Positive Airway Pressure) and BiPAP (Bi-Level Positive Airway Pressure) machines are used to treat sleep apnea — for the purposes of this diary I will use CPAP as shorthand for all of these machines. In sleep apnea, the airway in the throat collapses, preventing the inhalation of air for 10 seconds or more at a time. This causes the apnea sufferer to experience 'arousals' where they snort, snore and partially awaken in an effort to get air. All of the machines above provide a pressurized airflow into the airway via nose or nose and mouth, and use this air pressure to keep the airway from collapsing.
For example, I have apnea, and in testing, I stop breathing for 10 or more seconds 123 times per hour. So I use a CPAP at 15cm pressure (pretty high; my case is severe), and then I only experience 3-4 apneas per hour. Big difference.
Important caveat: CPAPs, BiPAPS and APAPs are NOT medical ventilators.
They cannot deliver a higher oxygen levels to the patient. Nor can they fine tune on the fly to meet patient needs. All they do is take atmospheric air and blow it into the lungs of the patient. CPAPs, BiPAPS and APAPS require a prescription to be purchased in the United States.
CPAP usage in less severe cases of COVID-19 is being considered more broadly:
Bioworld
Various other types of medical-grade breathing equipment also are starting to be assessed – even at-home ventilators and CPAP/BiPAP equipment for sleep apnea – to determine their potential usefulness for COVID-19 patients in the absence of standard ICU ventilators. ICU-grade ventilators typically cost as much as $50,000, while other less intensive ventilators can cost as little as $5,000.
So Banzhaf suggests the possibility of using existing CPAP (Continuous Positive Airway Pressure) machines, now already in very widespread use in homes to combat sleep apnea, as devices to help persons with respiratory problems due to the coronavirus, especially in less serious cases which do not require the full power and sophistication of expensive hospital-type ventilator machines.
Here's why:
First, the number of existing CPAP machines greatly exceeds the number of hospital ventilation machines, and, because they are simpler and less expensive, manufacturing capability can be increased far more quickly, very easily, and at much lower cost.
Second, CPAP machines, especially those with full-face masks, can provide a very significant increase in the amount of air (and therefore oxygen) a user can consume, and many can easily be adjusted to provide even higher air pressures than would ordinarily be required to overcome mild sleep apnea.
Third, those most at risk of respiratory problems from the coronavirus virus - i.e., those who are elderly and/or have other medical problems - are also the population most like to already have and use CPAP machines.
Are you an apnea patient? Do you have older machines that still work?
I had two old CPAP machines which still worked wonderfully, they were just replaced over time. I have loaned these machines out to friends; one had lung surgery to remove a cyst and has only partial use of that lung; the other is immunocompromised and also has asthma. They had to purchase new CPAP masks for their use but masks, while not cheap are not insane ($49 — $129). My thought is to flatten the curve - if they get COVID-19, they might be able to avoid the ER for awhile by using a CPAP at home, thus keeping two beds available for others.
But I don't know if this was the absolute best or wisest use of my 'backup' CPAP's. I also wonder if there are hundreds, or thousands of sleep apnea patients like me around the country who have older CPAP units gathering dust in a closet. How do we utilize those potential resources in way that is broadly beneficial? Should we distribute them as I have done? Bring them to hospitals? State or County health authorities?
Friday, Mar 20, 2020 · 8:24:36 PM +00:00 · AndyT
I am not suggesting a CPAP will replace a ventilator. All I am suggesting is that for more mild cases if it eases respiration even slightly it could keep those people from the ER — freeing up beds and valuable nursing/physician time for use with more severe cases.