CPAP use for Coronavirus mitigation & severe pneumonia

[cryonix]

here is my terrible translation ;-)

  systemdescription.pdf (Size: 683.39 KB / Downloads: 28)

h t t p s ://www.uni-marburg.de/de/fb13/halbleiterphotonik/the-breathing-project/the-breathing-project-1 
(should be daily updated)
they try to get an official approval !

Cryonix

[70sSanO]

I realize I may be off subject but I'm thinking about using an old CPAP full face mask when I go out to pick up groceries this afternoon.  I also think I'll include the small right-angle one-way flapper valve plugged into the mask.  Perhaps I should include a section of CPAP hose (I have some old hose) to locate the air inlet in another direction, perhaps behind me.  I don't have any N95 material, only cloth, that I could locate over the inlet to minimize solids, droplets, etc., from entering my breathing air.  Other than the small air exhaust hole on the right-angle flapper valve, there should be little chance of airborne crud getting through the mask and into me.

Somebody else also came up with this suggestion earlier in this thread but I didn't see any subsequent discussion about the idea (I've tried to read all postings -- difficult at times -- very, very helpful!).

Thank you!  Carl

Here is a link to another thread...

http://www.apneaboard.com/forums/Thread-...-n95-masks

The one thing I am wondering is if there are other materials than specific NXX be "somewhat" effective.  People are using dense cotton, but I'm not sure that is much better than nothing.  But, for example, can EVA foam or wetsuit neoprene work to some extent?

Is there any merit what-so-ever that material density (weave?) indicates resistance to particle size?

While this is bordering on the ridiculous, could 5 layers of even tissue paper provide a barrier?

John

[howeyb]

Here is an article that just came out yesterday from eurekalert.org/pub

ESA (European Society of Anaesthesiology)

CPAP (continuous positive airway pressure) breathing devices may delay respiratory failure, and help medical staff (also non-ICU experts) to avoid ICU admission when intubation is not feasible. 

https://www.eurekalert.org/pub_releases/...033120.php

[DeepBreathing]

Thanks Cryonix, great job. It's 01:20 here now so I'll read it in the morning.

[mafiawfb]

Disclaimer - medical information is merely information - not advice. If users need medical advice, they should consult a doctor or other appropriate medical professional.

https://www.youtube.com/watch?v=ZxbPcuAm_rE




1. Speakers introduction (0 – 03:00)
2. Opening Speech - Dr. Mark Elliott (03:01- 05:04)
3. COVID-19 Clinical Phenotype and CT appearance (05:05 – 31:31)
4. Escalation of Non-invasive Ventilatory Support (31:32 – 1:09:47)
5. Use home ventilators/CPAP for Non-invasive Ventilation and Invasive Ventilation? (1:09:48 – 1:16:00)
6. Does early tracheostomy have a role? (1:16:01 – 1:21:18)
7. Personal Protective Equipment while Performing HFNC & NIV (1:21:19 – 1:35:10)
8. COVID-19 Biomarkers (1:35:11 – 1:36:37)
9. ICU organization and service design when demand far exceeds supply (1:36:38 – 1:51:18)
10. Management for existing patients on HMV who get admitted to hospital (1:51:19 – 1:52:50)
11. Summary (1:52:51 – 1:55:32)
12. Closing (1:55:33 – 1:56:12)

Cannot post video links because I'm newbie.
Hope this information is useful.
Stay safe, stay health.


Moderator note:  link enabled & video embedded.

[mafiawfb]

Disclaimer - medical information is merely information - not advice. If users need medical advice, they should consult a doctor or other appropriate medical professional.

https://www.youtube.com/watch?v=cjIjSBq6WIU




Use of home ventilators in the acute setting.

Sections:
Experience of CPAP versus oxygen (0 – 10:22)
A trial of nursing patient prone (10:23 – 12:10)
Importance of palliative care (12:11 – 17:03)
Cough assist (17:04 – 18:31)
High flow nasal therapy (18:32 – 20:23)

Again, I cannot post video links because I'm newbie.
Hope this information is useful.
Stay safe, stay health.

Moderator note:  link enabled & video embedded.

[3rdMarDiv]

I agree with everything you just said… You got to do what you Gotta do.

I was only speaking from my personal standpoint and where possible trying to buy from a North American distributor.

It is probably also the case that many of the parts inside of both my machines are made in China.

Certainly not blaming anyone for being forced to buy from a certain supplier, but I think you know what I’m saying…

[SuperSleeper]

Yep, I hear 'ya 3rdMarDiv. I completely agree that if I can purchase stuff made here, it's much better. That's my usually strategy when buying products anyway. I'm just lamenting the fact that our once great manufacturing base here in the U.S. is all but gone now. That's what's causing us a lot of grief now during this crisis, with lack of pharmaceuticals, consumer products and other items we now outsource to China and other countries. I think that will change soon after this crisis is over, hopefully.

[Matt00926]

Gov Cuomo orders 2,750 BiPAP machines.

On slide during 3/31/2020 Update:

Nice catch John…! That is very encouraging information… Worse comes to worse… We have a effective tool in our homes.

My next curiosity is how they are deploying them and utilizing them… What are their procedures and protocol.

Thanks again

From what I've seen from RT's discussing vent management for covid-19...they emphasize high PEEP (being the most crucial parameter), controlling the max inspiratory pressures to prevent lung injury, moderate tidal volumes, higher than normal set respiratory rate, placing patients in the prone position being crucial for oxygenation, and sedation/neuromuscular blockade so the patient doesn't fight the vent and it somehow helps keep the peak pressures from spiking maybe due to asynchrony.

[geauxdbl]

I'm going to ask again, after reading cryonix' translation of that Breathing Project document:

They're working really hard to create a mechanical device to attach to a CPAP machine that will allow for IPAP of 20 and EPAP of 6

Isn't this just reinventing the wheel? Bilevel machines exist in large quantities in the world and do this already. Why aren't we just using them?