CPAP used for Covid-19

[TerryLH]

If you needed a ventilator for Covid-19, but none was available, would a CPAP machine sort of work?

It gets the air to your lungs.

Terry

[nzrick]

cpap doesn't pull air out, so not much use with a collapsed lung

[Sheryl]

No

[Mr Smithy]

NO - This is the type of machine people suffering from ARDS need

https://www.hamilton-medical.com/en/Products/Mechanical-ventilators/HAMILTON-C6.html

 

[PPMMUU]

noninvasive positive pressure ventilation (including CPAP) is a method that is ALREADY used in those with severe pneumonia but not yet in need of invasive ventilation

 

so

 

- CPAP is useful ( and is already used ) in some severe pneumonia patient ( including COVID pneumonia )

- those needed a ventilator CANNOT use a CPAP as a substitute

- a CPAP (for those needed a ventilator but couldn't get one) is better than nothing, of course. but it would not be an adequate treatment.

[mike787]

CPAP does not treat pneumonia directly, however it can reduce the work-of-breathing often seen with pneumonia and ARDS ... Near drowning patients may also have significant hypoxia and bronchospasm, both of which can be effectively treated with CPAP. With the positive effects of CPAP on non-cardiac pulmonary edema.

[Mr Smithy]

4 minutes ago, mike787 said:

CPAP does not treat pneumonia directly, however it can reduce the work-of-breathing often seen with pneumonia and ARDS ... Near drowning patients may also have significant hypoxia and bronchospasm, both of which can be effectively treated with CPAP. With the positive effects of CPAP on non-cardiac pulmonary edema.

CPAP can increase the work of breathing as exhalation against +ve pressure requires effort as opposed to exhaling to normal atmospheric pressure which is passive ........

[Sheryl]

Believe me, if you are anywhere remotely near needing assistance to breath you should not be trying to DIY.

[mike787]

3 hours ago, Mr Smithy said:

CPAP can increase the work of breathing as exhalation against +ve pressure requires effort as opposed to exhaling to normal atmospheric pressure which is passive ........

The application of CPAP maintains PEEP, can decrease atelectasis, increases the surface area of the alveolus, improves V/Q matching, and hence, improves oxygenation. It can also indirectly aid in ventilation, although CPAP alone is often inadequate for supporting ventilation, which requires additional pressure support during inspiration (IPAP on BiPAP) for non-invasive ventilation.  THerefore, it is better than nothing. 

[TerryLH]

Thanks to all.

Terry

[TallGuyJohninBKK]

https://www.npr.org/sections/health-shots/2020/03/27/822211604/cpap-machines-were-seen-as-ventilator-alternatives-but-could-spread-covid-19

 

Quote

 

CPAP Machines Were Seen As Ventilator Alternatives, But Could Spread COVID-19

• In the U.S., emergency plans developed by states for a shortage of ventilators include using positive airway pressure machines — like those used to treat sleep apnea — to help hospitalized people with less severe breathing issues.
   

  While that measure could stretch the supply of ventilators and save lives, it has a major drawback. Officials and scientists have known for years that when used with a face mask, such alternative devices can possibly increase the spread of infectious disease by aerosolizing the virus, whether used in the hospital or at home.

•  

   

  Indeed, that very scenario may have contributed to the spread of COVID-19 within a Washington state nursing home that became ground zero in the United States. First responders called to the Life Care Center of Kirkland starting Feb. 24 initially used positive airway pressure machines, often known as CPAPs, to treat residents before it was known the patients were infected with COVID-19....Redmond Fire has now discontinued use of CPAPs for COVID patients.

 

 

 

Quote

The key issue, Finigan said, is how the device connects to the patient. Ventilators require a breathing tube and operate as closed systems with a filter that traps any pathogens. Face masks generally used on CPAPs or BiPAPs allow air to escape, pumping the virus into the surroundings and potentially infecting other patients, caregivers or anyone nearby.

 

Edited March 29, 2020 by TallGuyJohninBKK

[mike787]

22 hours ago, Mr Smithy said:

CPAP can increase the work of breathing as exhalation against +ve pressure requires effort as opposed to exhaling to normal atmospheric pressure which is passive ........

Breaking news via BBC...Mercedes formula 1 teamed with doctors in italy to develop a CPAP device they can develop 1,000 devices/day.  Italy doctors found that over 50% of patients on CPAP avoided a ventilator and sedation.  THerefore, CPAP DOES WORK.

[Sheryl]

8 minutes ago, mike787 said:

Breaking news via BBC...Mercedes formula 1 teamed with doctors in italy to develop a CPAP device they can develop 1,000 devices/day.  Italy doctors found that over 50% of patients on CPAP avoided a ventilator and sedation.  THerefore, CPAP DOES WORK.

 

They are not using CPAP as it is.

 

They have retrofitted it with significant modifications.

 

It does save considerable time over building from scratch, so it is an advantageous approach. But by no means is it the case that a regular home CPAP device will do the trick and people should not think that it will.

 

One of the big drawbacks is that CPAP only delivers room air. People with viral pneumonia need a higher concentration of oxygen. In addition one needs to be able to adjust and control the pressure flow and the volume.

 

Again, anyone having significant trouble breathing needs to be hospitalized.

 

[mike787]

2 minutes ago, Sheryl said:

 

They are not using CPAP as it is.

 

They have retrofitted it with significant modifications.

 

It does save considerable time over building from scratch, so it is an advantageous approach. But by no means is it the case that a regular home CPAP device will do the trick and people should not think that it will.

 

One of the big drawbacks is that CPAP only delivers room air. People with viral pneumonia need a higher concentration of oxygen. In addition one needs to be able to adjust and control the pressure flow and the volume.

 

Again, anyone having significant trouble breathing needs to be hospitalized.

 

True.  It is a modified CPAP used to help when options are unavailable.  Not to be the first choice. 

[Mr Smithy]

Very few people with acute respiratory distress will tolerate CPAP which involves strapping an air tight mask to a persons face.