CPAP use for Coronavirus mitigation & severe pneumonia

[SuperSleeper]

I read the blue one (low-flow) is for children, or for those with pre-existing conditions like COPD who have trouble breathing already.  The green one (high-flow) is supposed to be for adults who have no real problem breathing out larger volumes of air.

I suppose for our purposes, you may want both, a green one for when the beginning stages of pneumonia hit, and the blue one for later on when you can't produce large volumes of air due to fluid in the lungs.

Just speculating here, of course.  

[SuperSleeper]

I'm hearing (on television & other shows) people are getting confused with some of the terminology.

So I'd like to define some terms that are being mis-used or misunderstood by many in the press:

There's three main "items" people are talking about-- ventilators, respirators & surgical masks.

They are not interchangeable, and they are completely different items used for different purposes.



VENTILATOR:  This machine (according to the National Institutes of Health, here) is defined thusly:

A ventilator (VEN-til-a-tor) is a machine that supports breathing. These machines mainly are used in hospitals. Ventilators:

• Get oxygen into the lungs.
  
• Remove carbon dioxide from the body.
  
• Help people breathe easier.
  
• Breathe for people who have lost all ability to breathe on their own.
  

RESPIRATOR:   A respirator is a mask designed to protect the wearer from inhaling hazardous atmospheres, including particulate matter such as dust and airborne microorganisms (such as a virus).  They are usually tight-fitting thicker "face masks" that provide protection for the mouth & nose only.   These include the popular disposable one-time-use N95, N99, & N100 face masks, plus other types of masks that are not disposable.  Disposable respirators are the most common and are usually made from a variety of filtering material.  Respirators provide better protection from viruses, but they do make it a bit more difficult to breathe, and the disposable variety become less effective over time as moisture build up increasingly reduces the effectiveness of the mask.


SURGICAL  MASK:  A surgical mask is usually a thin paper or cloth mask worn by medical staff.  It is not designed to protect the staff primarily;  instead it's designed to protect the patient from moisture droplets that may emanate from the medical staff's mouth (aerosol droplets during a cough, sneeze or simply talking).  Surgical masks also provide a small degree of protection to the medical staff from bodily fluids that may splash onto the worker's face area, but they provide little protection against small particles like viruses.


Surgical Masks (while better than nothing) do not provide a high degree of protection against coronavirus (for the wearer).

Respirators do provide a high degree of protection against coronavirus (for the wearer).

The subject of this particular thread is ventilators and the possibility of mechanically altering or changing settings on standard CPAP, Bi-level or ASV machines to act more like a hospital ventilator.

Just wanted to get these definitions out there in case anyone is getting confused by the media's mistakes.

[geauxdbl]

This is exactly the thread I was hoping to see.  

Here's the most informative description I've found so far of how Covid-19 kills:


https://threadreaderapp.com/thread/12389...48960.html

SARS-CoV2 attacks pneumocytes in lung, intestine, heart & cells lining blood vessels. In lung, CoV2 prevents cells from making biological detergents to keep lung passages open. Acute respiratory distress follows. O2 levels fall..but there's may be a dangerous underlying process.. 

..new work out of China yesterday says COVID-19 might also involve abnormal blood production. CoV genes 1 & 8 are predicted to interfere with heme, the red compound in blood, by kicking out the iron. Would explain why chloroquine seems effective as a treatment

It may explain why diabetics and elderly are more susceptible. Blood sugar levels usually increase as we get older, increasing the amount of glycated hemoglobin (HbA1c) (I've tweeted about this before). The authors suggest these people would be more susceptible to because... 

...the virus could more easily disrupt the heme in red blood cells. If so, the virus is very smart: it destroys the lung so patients can't take up oxygen AND reduces the body's ability to carry oxygen. (For this & other reasons, you should eat healthily the next 2 years)... 

It appears to be a dry cough, without mucus production or sneezing, so nasal congestion shouldn't interfere.  From my perspective, Postural drainage and using bilevel while lying prone with humidity and heat cranked up seems like the best approach.  Maybe daytime use at higher settings, and a return to regular pressure at night?  

And as a preventative measure, so does sinus irrigation (I already use a neti pot).

[srlevine1]

The manufacturer website for "Lunglute"

That may have been a typo... I think the product name is "LungFlute" or "Lung Flute".  Found nothing like that on Amazon, but did find some for sale on eBay for about $60 each.  However, they're shipped from India, and I'm pretty sure that ordering the product and actually receiving the product in a timely manner may be two different things altogether in this economic climate.  If I'm remembering correctly, India made a decision recently to halt shipment of all medical supplies out of the country for now;  not sure if that applies to eBay or not.

The original product is called the "Lung Flute" and was developed by Medical Acoustics. It requires a prescription IN THE UNITED STATES which is why you see them offered for sale from other countries. If you are going to order from a foreign country, I use PayPal and rely on their guarantee to ensure that I receive the product, it is as advertised, and is not a piece of crap forgery. The refund process may take up to thirty days, but I have yet to be stiffed by PayPal.

[srlevine1]

This is exactly the thread I was hoping to see.  

Here's the most informative description I've found so far of how Covid-19 kills:


https://threadreaderapp.com/thread/12389...48960.html

SARS-CoV2 attacks pneumocytes in lung, intestine, heart & cells lining blood vessels. In lung, CoV2 prevents cells from making biological detergents to keep lung passages open. Acute respiratory distress follows. O2 levels fall..but there's may be a dangerous underlying process.. 

..new work out of China yesterday says COVID-19 might also involve abnormal blood production. CoV genes 1 & 8 are predicted to interfere with heme, the red compound in blood, by kicking out the iron. Would explain why chloroquine seems effective as a treatment #CoronaVirusUpdate 

If this is literally true, then a cheap, common test for ferritin, a blood protein contains iron, may be the perfect screening tool for active disease. A abnormal ferritin test could indicate that something is going on and suggest further studies. Everyone can get a ferriting test just by asking for it as it is a common blood test for anemia -- no so the covid-19 test at this time.

@SUPERSLEEPER -- The message looks ok in my browser, but when posted contains HTML tags. Is this a problem on your end or my end?

[70sSanO]

I didn't want to start a new thread, since this is related in a way.  Because I'm 68 I know where I am on the ventilator medical food chain, but I still have to go to the store to get food.

Even if I don't want to, it appears that there might be a real need to wear some kind of protective respirator mask.  Cheap (not anymore) N95 disposable shop masks are what seems to be in demand but are tough to find.  But I have a used F20 non-vented mask an a used cushion.

So I got to thinking.  I have some 3M P95 cartridge filters in the garage.  What if I put them together?  I need to attach the filter; Probably with tape.  I'll use elastic as straps.  The protection has to be as good as the disposable ones.

John

[srlevine1]

I didn't want to start a new thread, since this is related in a way.  Because I'm 68 I know where I am on the ventilator medical food chain, but I still have to go to the store to get food.

Even if I don't want to, it appears that there might be a real need to wear some kind of protective respirator mask.  Cheap (not anymore) N95 disposable shop masks are what seems to be in demand but are tough to find.  But I have a used F20 non-vented mask an a used cushion.

So I got to thinking.  I have some 3M P95 cartridge filters in the garage.  What if I put them together?  I need to attach the filter; Probably with tape.  I'll use elastic as straps.  The protection has to be as good as the disposable ones.

John

It sounds like a great idea, but I have one consideration. Due to the limited volume of a tightly-sealed mask, wouldn't you be increasing your CO2, the difficulty of breathing, and possibly causing an issue with someone with impaired lung function?

Unfortunately, it doesn't protect your eyes which are said to be another entry point ... but it is better than nothing.

[SuperSleeper]

The original product is called the "Lung Flute" and was developed by Medical Acoustics. It requires a prescription IN THE UNITED STATES which is why you see them offered for sale from other countries.

I'm not sure that is completely accurate.  

That seems to be true for the brand name of "Lung Flute" according to their website, but I believe that's because their products have been approved for medical use by FDA. and thus approved for payment by health care insurance companies.  But the product itself is in a class of proven products called "Positive Expiratory Pressure (PEP)" and there are several other similar products that supposedly work just as good, but never bothered to get FDA approval for their devices, and those devices seem to work in identical fashion as to the "Lung Flute" brand, according to many reviews and info on medical websites... and they need no prescription.


I just ordered one from Amazon and it's already been shipped.  Provided no prescription at all.  Due to arrive Thurs or Fri.

Search Amazon for "Acapella Vibratory PEP Therapy Devices - Acapella DH with Mouthpiece".

The Acapella brand name is known in the medical community.  Several medical websites refer directly to that specific brand name.  Do some searching around and you'll see that.  I think these devices are like some drugs, some of them require a prescription if you want insurance to pay, but you can still get the drugs over-the-counter if you're willing to pay out-of-pocket. This is true of the nasal spray I sometimes use for my allergies.  Insurance pays for it, but I can also buy it over-the-counter at most pharmacies with no prescription.

That said, I just read that Amazon made a decision today to stop using their their warehouse space (fulfilled by Amazon stuff) for anything but necessary household staples and medical supplies.  Any "frivolous" or non-essential items will not be re-stocked, if the product is either sold by Amazon, or by a seller that uses Amazon fulfillment.  So I'm not sure if these PEP devices will considered "necessary household items" or "medical products" or not.  So if you want one, you may want to order it now.  Do a Google News search for "amazon warehouse news" and you'll see several news articles about this new policy decision that went into effect today (Tuesday, March 17)

I had just ordered a bag of diatomaceous earth for controlling bugs around the outside of my house.  My order was originally "fulfilled by Amazon", and I got a UPS tracking number for it.  But then today, I noticed that the tracking said "Shipment Cancelled".  I went to the Amazon website and wrote to the seller (not Amazon, but they used Amazon fulfillment).  A few hours later, I got an email from the company stating that they were fulfilling my order themselves, and gave me a new (this time) FedEx tracking number.  So apparently I got caught up in this new policy change, and Amazon told the company, "Sorry, we're not shipping this product", so to fulfill my order, they simply shipped me the product direct.

Things are changing fast, folks.

[srlevine1]

Search Amazon for "Acapella Vibratory PEP Therapy Devices - Acapella DH with Mouthpiece".

The Acapella brand name is known in the medical community.  Several medical websites refer directly to that specific brand name.  Do some searching around and you'll see that.  I think these devices are like some drugs, some of them require a prescription if you want insurance to pay, but you can still get the drugs over-the-counter if you're willing to pay out-of-pocket. This is true of the nasal spray I sometimes use for my allergies.  Insurance pays for it, but I can also buy it over-the-counter at most pharmacies with no prescription.

Things are changing fast, folks.

Thanks,

I just ordered mine and received an order confirmation for tomorrow via Prime. (BTW... the pic says Rx ONLY on the package). 



Steve

[70sSanO]

I didn’t consider CO2 building up, but I’ll test it first. I don’t think it will be an issue as it is used by painters and overspray gets on the filters.

The F20 Quiet Air venting area consist of just a series of small holes and goes through diffuser material. Of course the machine is pumping air in, but the exhale CO2 does get out.

The truth is that it will be impossible to not have to drive somewhere for essentials. If things continue to deteriorate, it will be better than nothing.

John