Tesla and SpaceX CEO Elon Musk said he ’d be sending desperately needed “ FDA - approve breathing apparatus ” to hard - hit hospitals across the nation dealing with the coronavirus crisis — but they have n’t been the high - grade sort needed to keep intensive aid patients alive . rather , those sent off so far appear to be Bilevel Positive Airway Pressure ( BiPAP ) machine of the variety used to do by nap apnea , according to aThursday reportby the Financial Times ’ Alphaville .
BiPAP machines are similar to CPAP automobile but have two insistency setting instead of just one . They cost around $ 800 , according to Alphaville , while ICU - ground level ventilators useful for dangerous cases broadly retail for up to $ 50,000 on the open market . Musk has said he secured around “ 1,255 FDA - okay ResMed , Philips & Medtronic ventilator ” from suppliers in China for statistical distribution , but Tesla - brand boxes in a photo tweeted by NYC Hospitals appear to show at least 40 of them are ResMed S9 elect BiPAP motorcar , which come along to be discontinued . ( It ’s not clear how many of the 1,255 respirator touted by Musk are these BiPAP machines . )
https://twitter.com/embed/status/1245502083463176193
Photo: Brendan Smialowski (Getty Images)
https://twitter.com/embed/status/1245502084977283072
It ’s tempting to view this as déjà vu of that time Musk promise to save a Thai soccer squad trapped in a cave with auseless “ submarine,”and it ’s not exactly a smashing tone for a billionaire to foretell “ FDA - approved ventilators ” and then fork out loud devices that are n’t really breathing apparatus , aren’tin short supply , and are far from desirable choice to ICU - level gear . But that does not mean BiPAP auto are whole useless given the crisis situation the U.S. is now in .
The FDA hasindeed released guidanceindicating that non - trespassing respiratory gimmick can be used to cover covid-19 patients — though they are unlikely to furnish sufficient O to patients doing poorly enough to end up in the ICU . Their use has also been questioned by the American Society of Anesthesiologists , which has notedthat the BiPAP and CPAP automobile “ may increase the risk of infectious transmission . ” The government issue is that high - grad ventilators are closed systems that employ take a breath tubes to fork up O to the lungs and strain the aviation supplying , whereas the rest apnea machines broadly use expression mask that can leak out air and help aerosolize the virus .
Screenshot: NYC Hospitals (Twitter)
fit in toKaiser Health News , CPAP machine are suspected of contributing to the major eruption at Life Care Center of Kirkland in Washington res publica , one of the early U.S. epicenters of coronavirus infection . There , 129 residents , staff , and visitors were infected with the computer virus , with at least40 associated death .
However , UCHealth decisive care specialiser Dr. Jeff Sippel told Kaiser that BiPAPs could be jury - rigged to act with ventilation tubes , as “ the ironware actually conform to . ” They would n’t needs make a lifesaving divergence in in truth at - risk patient , but could be used to aid external respiration in less vivid cases or for patient low on the list for ventilator ( such as inanticipated triage situationsas covid-19 patients flood tide infirmary ) . North Shore University Hospital medical theater director for respiratory therapy Service Dr. Hugh Cassieretold Gothamistthat aesculapian personnel at his hospital have been doing just that : attaching breathe tubes and a filter to BiPAP machines . They ’ve also been 3D printing connection to make the conversions , which are reportedly running depressed .
“ We ’ve started using them in hand brake event , ” Cassiere aver . “ We ’re not advocate ventilating the earthly concern with it . We ’re say you have two choices , no breathing apparatus and the patient choke , or expend this method , and that ’s the approaching we ’re taking . ”
It ’s not light whether all the ResMed S9 machines in doubtfulness are ones that could be effectively modified to support patient role . According to a working protocolpublished by Dr. David Reichand other Mt. Sinai Health Systems doctors , they were able to convert ResMed S9 VPAP ST machine pitch by Musk to critical aid capable systems . But the protocol remark that “ the repurposed non - invasive ventilators should be discontinued as before long as a sufficient supply of ventilators becomes available . ”
I remark that the model in the picture appear to be the ResMed S9 , which reckon on the software package / example may not be capable to support a paralyze / sedated affected role , and is not listed in Appendix B of the EUA , but some exemplar ( for instance , VPAP ST , VPAP ST - A ) could do the business .
— Anand C. Patel ( @anandcpatel)April 1 , 2020
Very grateful to Tesla for providing Resmed breathing machine that our squad was able to convert to critical care - open . Innovation by The Mount Sinai Hospital ’s squad in a crisis!https://t.co / ZH6zCuiL1l
— David L. Reich , MD ( @DrDavidReich)April 2 , 2020
Similarly , some medical personnel have weighed modifications to ICU - grade ventilators so that they can be used to affirm multiple patient — although some experts are implicated that doing so could further endanger patients already atlow betting odds of survival . Studies have shown thatfew covid-19 patientson ventilators survive , and those that do often have to rest on the machines for week , raising the risks of fatal complications .
“ We think it ’s large that Tesla purchased bilevel non - invasive breathing apparatus from a political platform of ours that we developed five years ago in Asia and transport them to New York , ” the CEO of ResMed , Mick Farrell , differentiate Alphaville . “ … The bilevels featured in Tesla ’s tweet are build on the same platform as our S9 CPAP machines for sleep apnea but deliver non - encroaching ventilation that can be good to many COVID-19 patients struggle to emit while taste to defend off this virus . ”
Farrelltold CNBCthat similar devices have seen panoptic use in Europe and China , but conceded that Musk ’s effortsmight be good directedtowards building batteries for usance with invasive inhalator .
Kaiser noted that some doc are sceptical , particularly about the use of the CPAP and BiPAP automobile in the field .
“ In general , we ’re just assure them not to expend it , ” University of Colorado School of Medicine associate professor of clinical medicine Comilla Sasson told the site . “ Because we are implicated about biotic community spread , and we have to assume that anybody with respiratory hurt is a COVID patient role . ”
Invasive ventilators are for bad typeface patients . selection rate at that degree is low , as Gov Cuomo has pointed out . Nonetheless , we come out delivery of intratracheal Medtronic whole in NYC tonight .
— Elon Musk ( @elonmusk)April 2 , 2020
In tweets on Thursday , Musk defendedthe donation and tell that hospitals take to get the devices were given “ exact specifications , ” with all confirming they would be of “ vital ” assistance . Musk also state that Tesla was in possession ofMedtronic intratracheal ventilator , which can be used in critical cases , and would begin delivering them to healthcare provider in New York City on Thursday nighttime .
COVID-19Elon MuskHealthTechnology
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