Users Would Donate CPAP Machines To Meet Part of Ventilator Shortage; Millions Are Available; Could Help Many With Moderate Breathing Difficulty
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WASHINGTON, D.C. (March 19, 2020) - With an anticipated shortage of hundreds of thousands of hospital ventilators predicted, it is somewhat comforting to learn than many who use CPAP breathing machines - to control snoring and/or to treat sleep apnea - would be willing to donate them to meet the needs of those who become afflicted with COVID-19, and who may have only moderate pulmonary difficulties which do not require the power and complexity of a hospital-type ventilator and highly skilled operators.
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Users Willing To Donate CPAP Machines
Professor John Banzhaf, an MIT-educated engineer with several patents, and who first suggested using CPAP machines - sometimes called "poor man's ventilators" - when hospitals run out of conventional ventilators, and then have many COVID-19 patients with breathing problems who might otherwise die, reported that his idea is catching on via the Internet, and that, to his surprise, many users say they would be willing to donate their CPAP machines if the ventilator shortage becomes as acute as many experts predict.
Some CPAP owners are altruistic, some already have older machines which they used in the past but no longer need, some don't need them any more, and some frankly admitted that they don't use the machines ordered for them because they are inconvenient, difficult to use, uncomfortable, etc.
Interestingly, Banzhaf's original idea of using CPAP machines instead of hospital ventilators, at least for those whose breathing difficultly was not so severe and serious as to require a conventional hospital ventilator, was based on that idea that there are many CPAP machines already in storage, and therefore immediately available when the need arises.
He also noted that there are many more CPAP manufacturers, and that they can more quickly increase their production because the machines are less expensive and less complex to produce.
CPAPs Do Not Require Pulmonary Technicians To Operate
Also, CPAPs are much easier to operate - most owners use them in their own homes without outside assistance - and therefore, unlike hospital ventilators, do not require pulmonary technicians to operate them; another great advantage since such specially trained operators are also expected to be in very short supply.
Millions of Americans already use CPAPs - machines which assist them in breathing by forcing air under pressure into the lungs of users - to limit snoring and/or to treat sleep apnea, so they are currently available, and there are many more in reserve.
Moreover, since they are far less complex and much less expensive than hospital-type ventilators, production could more quickly and more easily be substantially expanded, suggests Banzhaf.
So it is at least possible that CPAP machines might be used as a temporary stop gap for those whose ventilator needs are not as severe and as complicated, and certainly such use would be better for patients with less severe respiratory problems who otherwise might not be provided with any breathing assistance at all if the need at a specific hospital exceeds its current supply of ventilators - so that some patients may have to be left to die.
Although some have called CPAP machines "poor man's ventilators," Banzhaf suggests that they should more properly be termed life-saving stop-gap ventilators during the current crisis.
To deal with this life-threatening shortage of hospital ventilators, CNN's Dr. Sanjay Gupta suggested bringing old ventilators out of storage and trying to make them operable again, but this may not work well, and may not be sufficient if demands for life-saving breathing assistance continues to dramatically expand.
Also, trying to suddenly expand manufacturing capacity for these hospital machines also may not work, because they are both difficult and very expensive to construct.
Some Cases May Not Require Full Powered Ventilators
So Banzhaf suggests the possibility of using existing CPAP (Continuous Positive Airway Pressure) machines, now already in very widespread use in millions of homes to combat sleep apnea, as devices to help persons with respiratory problems due to the coronavirus, especially in less serious cases which do not require the full power and sophistication of expensive hospital-type ventilator machines.
Here are many reasons why:
First, the number of existing CPAP machines greatly exceeds - probably by an order of magnitude - the number of hospital ventilation machines, and, because they are simpler and less expensive, manufacturing capability can be increased far more quickly, very easily, and at much lower cost.
Second, CPAP machines, especially those with full-face masks, can provide a very significant increase in the amount of air (and therefore oxygen) a user can consume, and many can easily be adjusted to provide even higher air pressures than would ordinarily be required to overcome typical sleep apnea.
Third, persons most at risk of respiratory problems from the coronavirus virus - i.e., those who are elderly and/or have other medical problems - are also the population most likely to already have and use CPAP machines. So they and their family members are therefore familiar with and comfortable with using them.
Emergency Shortage Of Ventilators
Therefore, in the event of an emergency shortage of ventilators, these existing CPAP users could be asked to bring their units to the hospital with them where they might be used in all but the most serious respiratory distress situations requiring a sophisticated hospital ventilator machine and trained ventilation technicians.
Fourth, many CPAP units are used largely to limit snoring, and in some cases users might be able to do without them in an emergency without risk of serious health problems such as cardiovascular events.
Thus, some current CPAP users might be induced - e.g., with financial or other incentives - to permit their units to be used by hospitals or by other centers treating coronavirus patients if there is a severe shortage of hospital breathing machines.
Banzhaf, despite a lifetime of professional work and successes in the public health field, says he cannot fully evaluate the feasibility of using CPAP machines in some situations to help overcome the major anticipated shortfall of hospital ventilators.
He therefore hopes that those who are more knowledgeable will consider not only investigating and evaluating the idea, but also - if such use proves to be feasible - developing instructions and protocols to provide the necessary guidance for this novel use during a crisis.
The threat posed by the coronavirus is so serious and unusual that all possible approaches - including simple but novel ones such as using CPAP machines - should at least be considered and evaluated, if not actively tested in practice, argues Banzhaf, whose work getting antismoking messages on radio and television, and banning cigarette commercials, is estimated to have saved millions of lives.