CPAP use for Coronavirus mitigation & severe pneumonia

[slowriter]

ACT:  The current overall death rate for people infected with COVID-19 seems to be between 3% and 5% on average.  

Based on my reading, this is not a fact, in part because we have no idea how many undiagnosed cases there have been.

But it's certainly higher than the common flu.

[Gideon]

Fact. All CPAPs increase breathing efficiency. They resolve many oxygen desats eliminating the need for supplemental oxygen. We also see evidence of this in those individuals who suffer from treatment emergent Central apnea in the increased washout of CO2 triggering the event.

Is it possible pneumonia would impact this increased washout of CO2, so that people with bilevels might benefit from, and be able to tolerate, higher PS?

This is possible since I expect the pneumonia to decrease efficiency and the goal is to restore a normal breathing, not to hyperventilate the user.  
As with all treatments monitoring would be required.

[Sleep2Snore]

Ok, here is what happened to me when I was in hospital for Chemo@, I developed pneumonia and found I had pain when trying to breath.
I told the doctors and I got an X-ray to confirm I had pneumonia, then I got drugs to help clear it up, however, while these drugs were working I found it hard to breath at times.  I used the CPAP (It was a CPAP, no fancy machine at the time) and turned it up, this helped, but breathing out against the pressure was hard work, however, I was not getting a lot in and as I didn't get any breathing/respiration equipment from them I used the CPAP to shove in what I could.  Did it help?  Well, i am still here, but I found it helped a little, not a lot, but when you are struggling to breath, you will grasp at straws and I was glad of what air I got into my lungs.  It was hard work breathing out against the pressure as I had it full up at 20.
Would I advise someone to do this, no, ask a doctor for advice.
You will still need drugs to clear up the pneumonia anyway.
The advice we are getting here is to self isolate along with your family! 
That is fine, but who goes to get the drugs to clear up the pneumonia?
Most people are just finding they get a headache, fever, sore throat, cold, flue symptoms.  Some are getting pneumonia, but these are usually people with underlying medical conditions.  Unfortunately, these are the people most at risk, because of this some have died.
We are being told to stay away from crowds, keep washing our hands and if we feel any flue or cold symptoms to stay at home.

Anyway, take care everyone and stay safe.

[slowriter]

Would I advise someone to do this, no, ask a doctor for advice.
You will still need drugs to clear up the pneumonia anyway.
The advice we are getting here is to self isolate along with your family! 

I saw an interview with a health reporter last night, who was talking about the risks of even that, because you then spread to the family if not super careful. He was saying that China actually worked (though I missed how) to discourage family quarantining.

I'm only 50, without other health issues, but my plan for me and family if sick is to contact doctor if any breathing difficulties.

I think this thread is more about potential worst case scenarios, where ER and ICU care is being heavily-rationed.

[70sSanO]

This has been quite a thought provoking thread.

Most of the people here have equipment and masks, cushions etc. that have been set up for them. I am the only one on xPAP in our family, for now. Our kids are in their early 30's and are not showing any signs. My wife doesn't need it and has admitted that it would be tough for her if she had to.

I have no idea what is going to happen next if the toilet paper joking turns more serious. My wife and I are both in our 60's, in generally good health, but you never know. But, just to be on the safe side, I decided to pickup a small F20 cushion and headgear For Her. I also bought an N20 frame and associated parts to build up a small or medium nasal mask with a Std and For Her headgear. I don't want to be an alarmist and I don't anticipate ever needing them, except maybe having to pass them on to our kids some day, but if a worst case does happen in our area, I at least want to be able to help her as best I can.

John

[srlevine1]

I got a note from my sleep doctor's group ... If you use a device at night for sleep apnea, make sure it remains away from where people could cough, sneeze and breathe on it, and clean it regularly.

There seems to be a question of CPAP use by a person with the coronavirus in the proximity of uninfected individuals due to the potential spread of the disease by the exhausting moist air. It seems to be common sense that someone who is sick would isolate themselves from others.

[sheepless]

I suppose masks vent at greater rate or force than normal expiration but we expel warm moist air anyway so the problem is proximity under any circumstances. I wonder how much more problematic cpap expiration would be. I'm sure it's a good cautious reminder but in the context of this thread, the danger of not using cpap strikes me as greater than the danger of using it, for apneacs & sick people that can't get better treatment due to extreme circumstances. caregivers will have to be cautious in any event & maybe more so around a sick papper.

edit: I might have overlooked the main point that the pap machine user might be at greater risk while using the machine within say 6 feet of an infected person. in that case I want that person recovering in another room & not coughing near my me or my machine.

[SarcasticDave94]

I don't know if this bit of info helps, regardless here it is: note I have COPD and mixed Apnea, so my breathing is already messed up, the bout of pneumonia I had last July dropped my normally very good for COPD patient oxygen content level from 97% to about 91-92%, they put me on oxygen at 2L/min for first 24 hr. then dropped it to 1 L/min afterwards for 48 hr. The ASV and other xPAP devices increase effective breathing like bonjour said on Treatment Emergent CA. It is possible these xPAP devices then would be "out of the box thinking" helpful to increase breathing.

Tis a shame we don't know how to up the pressure...

[SuperSleeper]

I think this thread is more about potential worst case scenarios, where ER and ICU care is being heavily-rationed.

Exactly.  If anyone has ideas, post them.  Brain-storming is all about getting as many ideas out there in front of everyone as quickly as possible.  That doesn't mean that every idea will work or will be practical.  What brain-storming does is stimulate out-of-the-box thinking.  Your ideas may sound silly to one person, but may actually help to stimulate another person's thoughts, where the result over time is an actual working solution that may have never happened had you not posted your seemingly "silly" idea.

[SuperSleeper]

Tis a shame we don't know how to up the pressure...

That is the kind of statement or idea that might stimulate someone with a bit of knowledge on CPAP mechanics into thinking, "Wait a minute,  I think that actually might be possible".

We simply never know, folks.  Good comment, Dave.