Could Sleep Apnea Machines be a solution to the ventilator shortage?
Doctors at New York-based Northwell Health made extra ventilators from breathing machines for people with conditions like sleep apnea and shared instructions online Tuesday.
The health system, which has 23 hospitals in New York, has not run out of ventilators but wants to be prepared for a possible “mega-tsunami” of coronavirus cases, Dr. Hugh Cassiere, who worked on the technology, told FOX Business.
“The state government has been very helpful distributing ventilators not just to our health system but to others,” Cassiere said. “You can quickly deplete your supply. You thought you had enough ventilators, now you don’t.”
New York Gov. Andrew Cuomo mentioned the innovation as one of a “number of options” during a press conference Tuesday.
“Northwell developed an idea to use a BiPAP machine,” Cuomo said. “We’ve ordered 7,000 of those. … We’re working and figuring it out.”
Cassiere said another doctor in the system has used the converted machines to save lives.
“You have two alternatives: The patient dies or you think of something else,” he said. “This is the something else.”Cassiere, who is the medical director for respiratory therapy services at North Shore University Hospital, described the conversion as a last-ditch option.
Cassiere and his colleagues at Northwell converted their fleet of Philips Respironics V60 BiPAP machines into respirators by adding 3D-printed adapters so patients can be intubated and particulate air filters.
“Everything that needs to be done is built into that machine. That’s one of the reasons why we put in the press release this particular machine with the pressure control option,” Cassiere said.
Drs. Stanley John, Hugh Cassiere and Todd Goldstein collaborated on turning BiPAP machines into backup ventilators and fitting them with 3D-printed adaptors (pictured).
Northwell health systems are sharing their innovations in hopes of helping patients and health care workers across the country. For example, researchers from Duke Health are spreading the word about a new way to decontaminate N-95 masks, key personal protective equipment that’s been in short supply as the number of coronavirus cases confirmed in the U.S. grows.1
If you have trouble breathing, a BiPap machine can help push air into your lungs. You wear a mask or nasal plugs that are connected to the ventilator. The machine supplies pressurized air into your airways. It is called “positive pressure ventilation” because the device helps open your lungs with this air pressure.
What Makes BiPAP Different from CPAP?
CPAP machines have been the go-to treatment for obstructive sleep apnea. CPAP machines deliver a steady, continuous stream of pressurized air to patient’s airways to prevent them from collapsing and causing apnea events. After a CPAP titration study, your sleep technician and doctor will determine the pressure settings for your CPAP machine and set the machine to deliver that exact amount of pressure continuously.
CPAP machines can only be set to a single pressure that remains consistent throughout the night. However, many CPAP machines have a ramp feature that starts off with a lower pressure setting and gradually builds to the prescribed pressure. This comfort feature simply makes the pressure at the beginning more tolerable and less immediate, once the pressure builds to the required setting, it stays at that setting for the rest of the night.
What is BiPAP Good For?
One of the complaints about CPAP devices is that some patients find the constant singular pressure difficult to exhale against. For patients with higher pressure strengths, exhaling against the incoming air can feel difficult, as if they’re having to force their breathing out.
BiPAPs can also be set to include a breath timing feature that measures the amount of breaths per minute a person should be taking. If the time between breaths exceeds the set limit, the machine can force the person to breath by temporarily increasing the air pressure.
The main difference between BiPAP and CPAP machines is that BiPAP machines have two pressure settings: the prescribed pressure for inhalation (ipap), and a lower pressure for exhalation (epap). The dual settings allow the patient to get more air in and out of their lungs.
Who Would Benefit from BiPAP Therapy?
- BiPAP machines are often prescribed to sleep apnea patients with high pressure settings or low oxygen levels.
- BiPAPs are often used after CPAP has failed to adequately treat certain patients.
- BiPAPs can be helpful for patients with cardiopulmonary disorders such as congestive heart failure.
- Often prescribed to people with lung disorders or certain neuromuscular disorders.
Why Not Use CPAP with C-Flex Instead of BiPAP?
Another difference between BiPAP and CPAP with C-flex is that the pressure relief from C-flex is not a fixed amount, and the pressure drop can vary from breath to breath, whereas the BiPAP maintains a set, prescribed exhalation pressure.
Ask Your Doctor About the Benefits of BiPAP
Depending on the results of your CPAP titration study, more than likely your doctor and sleep technician will know outright if a BiPAP machine is right for you. However, if you’ve tried CPAP and find the pressure settings too difficult to manage exhaling against, talk with your doctor and see if a BiPAP machine is right for you.
The Alaska Sleep Clinic diagnoses and treats thousands of patients every year in Alaska suffering from sleep apnea. Often as a result of our diagnosis, patients are prescribed CPAP or even APAP machines for therapy. However, compliance is one of the keys to successful treatment, and if you’re finding that your CPAP pressure settings are too difficult to manage, give us a call and we’ll help you find the proper alternative, which may just be a BiPAP machine.
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