由 John R. Fischer
, Senior Reporter | April 07, 2020
Clinicians at Mount Sinai Health System in New York are reconfiguring hundreds of donated sleep apnea machines into ventilators to treat patients with severe cases of COVID-19.
A team of pulmonologists, anesthesiologists, sleep and critical care specialists, and medical students are creating the makeshift respiratory devices from a shipment of 200 ResMed VPAP ST machines donated by Tesla CEO Elon Musk. They are also sharing protocols and instructions for how to use the systems with other hospitals and the Greater New York Hospital Association to combat the nationwide shortage of invasive ventilators.
Dr. Charles A. Powell, chief of the division of pulmonary, critical care, and sleep medicine, and chief executive officer of the Mount Sinai – National Jewish Health Respiratory Institute, says the solution can be used “in patients who do not require all the power of a regular ventilator, freeing up those conventional devices for the acutely ill. Our objective is to share our protocols widely with our colleagues around the globe facing this crisis. This project is a demonstration of the success of the team science collaborative research infrastructure at Mount Sinai that allowed us to make these innovations quickly.”
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The reconfigured device features an endotracheal tube that replaces the typical mask, which can present a risk of COVID-19 aerosolization. It also is equipped with alarms to alert clinicians to problems in air flow; and features that enable doctors and respiratory therapists to view and control machine settings from outside the patient’s room, so they do not need to enter to make minor adjustments and risk exposure.
A prototype was tested in the Simulation HELPS Center at Mount Sinai, a laboratory run by the department of anesthesia. Two floors of the medical school’s library have been set up as a staging area for the makeshift assembly line. The VPAP machines are considered a preferable alternative to splitting ventilators between two patients at the same time, a move that many hospitals view as a last resort.
Like Mount Sinai, many health systems have been forced to become creative with the technology at their disposal to make up for the lack of ventilators available. Northwell Health, for instance, recently converted 300 anesthesia machines into ventilators
Medical students from the Icahn School of Medicine at Mount Sinai wrote the instructional user manual in one day. They are currently assembling machines to be used throughout the health system’s eight hospitals in case of a shortage.
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