Non Invasive Positive Pressure Ventilation to Minimize Aerosolization for COVID 19
Non Invasive Positive Pressure Ventilation to Minimize Aerosolization for COVID 19
Patients presenting to the emergency department, or needing hospitalization, for a variety of
 medical conditions often require non-invasive ventilation (breathing support). For example,
 for a person with shortness of breath as a complication of COPD (Chronic obstructive
 pulmonary disease) the gold standard of care requires application of a BiPAP machine.
 However, in the current environment of COVID-19, the aerosols produced by this machine in a
 COVID-19 positive patient pose serious potential harms to healthcare providers and other
 patients. All patients with similar symptoms to COVID-19 need to be treated as positive until
 definite testing determines otherwise. The best test available for COVID-19 takes up to 4
 hours to determine the patients status, which is too long to delay application of a BiPAP.
 This could lead to either a delay in care or the need for invasive breathing measures
 (intubation), which requires intense resource utilization, may not be in line with a
 patient's goals of care, and could cause serious harms (i.e. infection, medication reactions,
 etc.) in patients who do not need it. The use of a closed-loop BiPAP machine in which no
 expired air is released into the environment would solve these problems. Building off the
 failures of a similar approach that was trialed in Italy in response to the COVID-19 crisis,
 this project will develop and test a novel closed-loop BiPAP system.
Inclusion Criteria:

 -  Patient with respiratory failure due to primary pulmonary pathology.

 -  Patient who is selected for BiPAP or CPAP by the health care provider

 Exclusion Criteria:

 -  Age <18 years.

 -  Respiratory failure due to non-pulmonary pathology.

 -  Impaired consciousness (Glasgow coma scale <10).

 -  Patients with contraindications of NIV.

 -  Severe upper gastrointestinal bleeding.

 -  Chest trauma.

 -  Agitated or violent patient.