Yes, but the demand projected for ventilators seems to exceed the entire existing supply, and obviously dwarf the uses for all other conditions combined.
There are way too many different brands and types of CPAP machine for anyone to make any sort of sensible comment here. They aren’t all the same. Some of them do have a backup rate that could be used to mandatory mechanical ventilation, but that can’t be readily altered at the bedside in the models I have used. The use-case is radically different to the ICU.
We are talking about negative pressure mechanical ventilation. Positive end expiratory pressure is just one way of splinting open alveoli. Maintaining recruitment and V/Q matching in ARDS can be achieved in multiple ways, including negative pressure mechanical ventilation.
Interesting, I'd be curious to know more. My understanding of NPV is that it's primarily useful in cases when the lungs are generally "functional" and some other issue is preventing adequate ventilation.
Anyway, the ventilator hardware is relatively easy to make, a gas pump, reduction and humidifier, plus a few hoses.
Literally your granddad's CPAP sleep apnea machine is (almost?) good enough, if it has tuned oxygen intake. I would wager intubating actually makes most problems worse in case of damaged lungs, but with low odds only.
The real problem will be getting actual oxygen (concentrators are not free) and people to tune the system.
Theoretically yes, in fact it may actually be better. We have largely abandoned negative pressure ventilatory support for a number of practical reasons. Not least is that once you have intubated a patient, they are less contagious!
On more than one occasion I have "broken the rules" or Macgyvered my way out of a life-threatening situation (for my patients), either with equipment or drugs. This is a crisis. Our systems aren't working fast enough to cope.
The flow direction issue is partly addressed by the unidirectional valves in many ventilators/anaesthesia machines. The bigger issue is staffing expertise, I fear.
Thank you for pointing this out! I’m trying work out how to get in touch with this guy, unfortunately he has turned off all comments.
I’m not sure I understand your question: do you mean if the one patient is getting hyperventilated? My suggestion is to set the pressure settings to ventilate the poorly compliant compliant lung, then use the flow restrictor to compensate on the more compliant lung.
Unfortunately, in the modern world of electronic medical records, we do need access to a stream of measurement data. Historically this has been obtained using one-way serial port data streams, which is probably safer than having a network stack accessible to the web.
The users (anaesthesiologists and hospital administrators) don’t understand these problems. (I’m an anaesthesiologist)
I think it's a systems issue not really a software one. You need some sort of gap between the control unit (which can kill people) and the monitoring system which shouldn't be able to.
Would be perfectly reasonable to pass monitoring data from the control unit via a tx only channel to a networked monitoring device. For instance using a digital opto-coupler to galvanically isolate the two units.
This is not business as usual. We are already using various hacks to overcome the shortages, any improvement is worthwhile in the very short term.