[evan_au (OP)]

Around the world, hospitals are trying to find and commission as many ventilators as possible, to cope with the upcoming tsunami of breathing difficulties due to COVID-19 infection.

I heard a suggestion that perhaps low-cost CPAP machines could provide some breathing support, and reduce the number of people needing to go onto the limited number of (expensive) ventilators.
- CPAP machines were originally developed to treat conditions like snoring and sleep apnea, which causes symptoms like sleeplessness and tiredness during the day
- CPAP acts to keep the airways open, including the tiny alveolar sacs that collapse in those with severe breathing difficulties
- I've talked to a number of people who have tried these CPAP machines; they often found the face mask to be uncomfortable - so there must be many of them sitting in cupboards around (rich) countries
- Perhaps it's time to conscript idle CPAP machines into the war on COVID-19?
- Especially if they could be fitted with an oxygen hose to the air intake, they could help improve oxygenation levels in people with breathing difficulties - and keep them off a ventilator

What do you think?

Listen (10 minutes) or read the transcript: https://www.abc.net.au/radionational/programs/healthreport/cpap-treatment-coronavirus/12101868
See: https://en.wikipedia.org/wiki/Continuous_positive_airway_pressure

[Petrochemicals]

I have grave doubts about respirators for resipatory conditions, many people get up from sleep and have a good cough, so sedating people for days and shoving a tube down there throat whilst they are lying face down seems like a bad idea. What is causing the inability to draw breath ?

[set fair]

From my limited knowledge CPAP machines (in an oxygen rich environment or with an oxygen rich input) sound very sensible, they maintain a positive pressure in the lungs which better informed people than us say is important. You get a lot more CPAPs than ventilators for your buck.

[evan_au (OP)]

What is causing the inability to draw breath ?

Direct destruction of lung tissue by the virus
- Inflammation of the lung due to the immune response to the virus
- The lining of the lung thickens. This produces characteristic light patches on an X-Ray, and makes it harder for oxygen to pass through the lungs into the bloodstream (and carbon dioxide to pass in the reverse direction)
- Mucous buildup
- Lung collapse
- Pneumonia
- Exhaustion from spending too long trying (unsuccessfully) to catch a breath

people get up from sleep and have a good cough, so sedating people for days and shoving a tube down there throat whilst they are lying face down seems like a bad idea

A CPAP machine can't replace a ventilator (for those who really need it) - but it might avoid someone going on a ventilator?

Having people conscious (in a CPAP machine) means that they can:
- Clear their lungs
- move around a bit to keep muscles active, blood flowing and avoid bed sores
- feed themselves
- take any necessary medicines
- possibly take themselves to the toilet(?)
- definitely call a nurse if they get worse

For someone sedated on a ventilator, regular attention by a nurse is necessary
- They will have a catheter for urine = risk of infection
- They are fed through a stomach line (no exercise for the gut and microbiome)
- bed sores and muscle atrophy are real problems

The patient:nurse ratio is a lot more achievable with CPAP machines than with a ventilator.
- Now it just needs some evidence of effectiveness...

See: https://en.wikipedia.org/wiki/Ventilator
 

[set fair]

I think Evan has it right. CPAP machines can be used with nasal canular. Being sedated is just going to slow your body down, lower your metabalism and reduce your ability to fight the infection. One would like to hear what the doctors in the ICU wards think, but little chance of this. If they've been given ventilators not CPAP machines they will be gagged if they think that's wrong.