A NYC hospital has figured out how to turn sleep apnea machines it got from Elon Musk into ventilators for coronavirus patients

ylee@businessinsider.com (Yeji Jesse Lee)
  • T
    Tom
    Been on a BIPAP for years, you can vary volume up to 22cm.
    the key was to stop virus from getting out, GREAT TEAMWORK.
    Lots of machines in stock around the country. one 10th the cost
  • D
    Dann
    Great job docs. Innovation in a time that it is truly needed. You work with what you got and these guys did a great job.
  • J
    Jimbeaut
    Necessity is the mother of invention and we love this great step forward!!!
  • M
    Marlene
    GOD BLESS THEM FOR THIS ACTION
    OF LOVE....
    A RAY OF SUNSHINE
  • C
    Covfefe Whopper Lover
    This is why we live in the greatest country in the world! Seizing an opportunity to help in the middle of a crisis!
  • j
    john
    There called b-paps and yes they can! They are commonly used as vents at most hospital, surprised the author of this article was unaware of that! hospitals
  • G
    Gelila Nadew
    Really there. Is no secret among respiratory therapists who have been using these for non invasive ventilation for decades
  • J
    Jeff P
    This is why humanity is so great. We turn desperation into innovation.
  • K
    Kevin
    I guess Musk does not know the difference between a sleep apnea machine and a ventilator!
  • J
    Jonathan
    Hello, I’ve been a Respiratory Therapist for 13 years. I have worked in facilities ranging from small community based hospitals to Level 1 trauma/ tertiary care centers. This is a mischaracterization of the use of ventilators in the treatment of ARDS. It is true that higher levels of positive end expiratory pressures (PEEP) are utilized in treatment, but we never start at the high end. Often, baseline PEEP is set at 5-8 cmH2O, this mitigates the fact that we’ve bypassed the natural airway system that would not normally allow for complete derecruitment of the lungs. This pressure simply maintains a natural amount of surface tension allowing the alveoli to remain open. Therapeutic PEEP starts at 10 cmH2O, this is where we begin to use this pressure to increase the partial pressure of Oxygen paO2 at the alveolar level. Generally, we only need to increase PEEP if the fraction of inspired oxygen (FiO2) are toward the high end (60-100%). Since FiO2 delivery tops out at 100% it is PEEP that makes the difference for patients that continue to be hypoxic at 100% FiO2 delivery. 

    There are multiple classifications of lung failure: hypoxic, hyper-carbic, mechanical, and organ failure, or any combination. So there must be a differentiation. Patients presenting with failure secondary to Cov-2-19 seem to present with a combination of hypoxemic Respiratory failure secondary to organ failure. 

    Covid 19 attacks the type II pneumocytes, a cell in the lungs. These cells produce pulmonary surfactant which assists in reducing surface tension in the lungs and keeps the alveoli open naturally. Without surfactant the alveoli will begin to collapse and the airway and lungs will have an increased resistance. This is where the PEEP comes in avoiding that collapse. If PEEP is not utilized and the alveoli is allowed to collapse, then the pressure required to deliver the next breath would force the alveoli open, which would cause harm to the lung tissue. 

    As Covid attacks and destroys the type II pneumocyte the cellular death begins to accumulate and cause an exudative infection. This substance is serum, dead lung tissue, and white blood cells. This begins to fill the surrounding alveoli resulting in a loss of oxygen exchange space both from dead tissue and from the surrounding alveoli being filled with infective fluid. 

    This is in contrast to High Altitude Pulmonary Edema, which is a result of the body’s peripheral vasculature dilating while the pulmonary vasculature constricts. This drive fluid from the capillary beds around the lungs into the alveoli. This does not cause cellular death or infection and is often easily fixed by reducing elevation, applying oxygen, or using a hyperbaric chamber. So, In short this disease process does not mimic HAPE, simply because it primarily effects the periphery of the lungs. 

    When patients reach this level of illness the ventilator is the only option to save their lives. A high flow nasal cannula will work in the short term, but not at this level of illness. The damage is not being produced by the vent, it’s being produced by the virus. The vent is just the last ditch effort at keeping someone alive. There are many other factors that go into this topic. I will say, just because a person is a physician doesn’t mean they understand the physics and theory of mechanical ventilation and many defer to our expertise. If you want to talk to a physician about this topic it should be a Pulmonary Intensive Care physician.