Abstract
BackgroundThe study aims at solving the problem with the limitations of the homecare CPAP equipment such as sleep apnea devices in the treatment of COVID-19 pneumonia. By adding an advanced, rapid-to-produce oxygenation module to existing CPAP devices we allow distributing healthcare at all levels, reducing the load on intensive care units, promoting treatment in the early stages at homecare. A significant part of the COVID-19 pneumonia patients requires not only an oxygen supply but also additional air pressure. Existing home care devices are able to create precise positive airway pressure, but cannot precisely measure supplied oxygen concentration. Either uses uncertified and potentially unsafe mechanisms.ResultsThe developed system allows using certified and widely available CPAP (constant positive airway pressure) devices to perform the critical function of delivering pressure and oxygen to airways. CPAP device is connected to the designed add-on module that can provide predefined oxygen concentration in a precise and stable manner. Clinical test results include data from 12 COVID-19 positive patients. The device has been compared against certified NIV (non-invasive) equipment under 6–20 hPa pressure and 30–70% FiO2. Tests have proved that the developed system can achieve the same SaO2 (p = 0.93) and PaO2 (p = 0.80) levels as NIV with clinically insignificant differences. Test results show that the designed system can substitute NIV equipment for a significant part of COVID-19 patients while leaving existing NIV devices for unstable and critical patients. The system has been designed to be mass-produced while having medically certified critical components.ConclusionThe clinical testing of the new device for oxygen supplementation of patients treated using simple CPAP devices looks promising and could be used for the treatment of COVID-19 pneumonia.
Highlights
The study aims at solving the problem with the limitations of the homecare Continuous positive airway pressure (CPAP) equipment such as sleep apnea devices in the treatment of COVID-19 pneumonia
These options can be maintained by using non-invasive ventilation (NIV) applying positive end-expiratory pressure (PEEP)
The results of this study showed no statistically significant clinical differences between NIV and modified CPAP+, proposing a further discussion regarding the cost-effectiveness of the solution during the state of emergency
Summary
The study aims at solving the problem with the limitations of the homecare CPAP equipment such as sleep apnea devices in the treatment of COVID-19 pneumonia. The management of COVID-19 caused type 1 respiratory failure patients includes the administration of additional oxygen and prevention of distal airway and alveolar collapse [2, 3]. These options can be maintained by using non-invasive ventilation (NIV) applying positive end-expiratory pressure (PEEP). Shortages in the number of available NIV or HFNC, as well as high costs of the devices, provide several significant limitations, especially during the outbreak when time and expenses are crucial [7]. A cheap and rapidly produced solution must meet the criteria of clinical efficacy similar to the efficacy of NIV or HFNC
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