Non Invasive Positive Pressure Ventilation to Minimize Aerosolization for COVID 19

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's21 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

COVID-19

Interventions

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Outcomes

Primary Outcomes

Total Leak Volume of Non Invasive Ventilation Mask

The primary objective of this study is to assess if the mask device leaks when attached to a patient's face in real-world use. This outcome will be measured by having a researcher assess the physical seal on the patient four times throughout the device's use. The researcher will also screen the non-invasive ventilator machine for indications that the leak alarm has been triggered throughout the participant's engagement in the study. This outcome will be measured by total leak volume litres/minute.