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wiki:cpep [2020/03/30 12:31]
mwxfaw
wiki:cpep [2020/03/31 17:21] (current)
mwxfaw
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   - Free all IC rated ventilation units for those patients who are not (yet) in a critical state (estimated to 6-10%)   - Free all IC rated ventilation units for those patients who are not (yet) in a critical state (estimated to 6-10%)
   - Step from CPAP to IC ventilation only for critical situation   - Step from CPAP to IC ventilation only for critical situation
 +
 +====== Indications for mechanical ventilation ======
 +
 +Non-invasive ventilation (NIV) therapy provides both oxygenation and ventilation support and can enable physicians to tailor ventilation pressures and flows to match the patient’s breathing patterns and needs. Vigilance is required to ensure timely endotracheal intubation and positive pressure ventilation if a patient’s clinical status deteriorates. If a patient develops acute respiratory failure with documented or suspected COVID-19 infection fails trials of noninvasive respiratory,​ they may require endotracheal intubation and positive pressure mechanical ventilation.
 +
 +====== Benefits of CPAP (Continuous Positive Airway Pressure) ======
 +
 +  * Increase amount of inspired oxygen
 +  * Decrease workload of breathing
 +  * Reduces need for intubation
 +      * Intubation requires ICCU (Intensive and Critical Care Unit) stay
 +        * Increased exposure to risk associated with complications due to intubation
 +        * Increases overall hospital length of stay
  
 ====== Usage of CPAP Devices ====== ====== Usage of CPAP Devices ======
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   - A Filter to prevent contamination in the outflow   - A Filter to prevent contamination in the outflow
   - A pressure control valve which ensures that the pressure in the lung will not rise to dangerous values; it should stay between 5 upto 50 cm of water   - A pressure control valve which ensures that the pressure in the lung will not rise to dangerous values; it should stay between 5 upto 50 cm of water
 +
 +====== Recommended setting according to our experience and ventilation mode ======
 +
 +  * CPAP: PEEP between 6-10 cm H2O (be aware of possible leakage from expiratory valve!)
 +  * BiPAP: PEEP is recommended with a minimal inspiratory assistance (e.g: PEEP 8 cm H2O, AI 4 cm H2O) and to adapt O2 according to sp02 (<92%)
 +
 +<font inherit/​inherit;;#​e74c3c;;​inherit>​**WARNING:​ The solution described in this document is an EMERGENCY solution that could potentially be applied answering the challenges of the current COVID-19 crisis. It is NO regular approved method that has been clinically validated and contains (some tailor made) components that do not have a CE mark for clinical usage! Application of the solution and its components is the full responsibility of the medical professional responding to the COVID-19 crisis**</​font>​