PESHAWAR: A senior physiotherapist has asked the government to allow use of Continuous Positive Airways Pressure (CPAP) device as a ventilator for Covid-19 patients requiring less oxygenation on trial basis.

“We can save lives because the province has been struggling to deal with Covid-19 patients, who need supply of oxygen. Ventilators are short in supply as well as expensive but CPAD devices are available in the market and can be used for mechanical ventilation of the patients,” Dr Mehboob Rehman, a former head of physiotherapy department at Hayatabad Medical Complex, told Dawn.

He said that they had used CPAP for management of hundreds of injured, who had been brought there during Afghan war from 1982 to 1985, in ICRC surgical hospital. The same could be used for the coronavirus patients, requiring mechanical ventilation, he added.

Dr Mahboob, who is also chairman of Mahboob College of Physiotherapy, said that use of CPAP device was gaining worldwide currency and had become important component of emergency medicine and critical care. It could be better substitute to ventilators as those were abundantly available, cheap and could also be operated easily, he added.

Shortage of ventilators for Covid-19 patients prompts Dr Mahboob to present the idea

Dr Mahboob said that during Afghan war, the patients with chest injuries at ICRC hospital were having limitations of lungs expansion and oxygen acceptance so they were given CPAP after operation to maintain their oxygen level and expand lungs. The patients’ recovery was speedy and marvelous, he added.

Subsequently, the patient’s X-rays showed good lungs expansion in a day or two and reduced the hospital stay and sent home, he said. He said that it could be practiced in chest conditions in surgical and medical units as well. Following the onset of Covid-19, there was a worldwide demand for ventilators due to which patients suffered, he added.

“The coronavirus patients need good oxygenation. If we apply this on trial bases, we can manage this local device for experimental purposes. CPAP is widely used in sleeping apnea by chest physicians throughout the world and its portable small devices are available in the market,” said Dr Mahboob.

He said that many patients with shallow breathing during nights were advised by chest physicians to use of CPAP.

He said that health experts were discussing conversion of CPAP into ventilator. “The experts have also observed very rightly that due to its mask there is risk of spread of coronavirus. Due to its nasal prong and from mouth exhalation or expiration phase, the droplets from which may spread the virus,” he added.

However, Dr Mahboob said that with little modification, that limitation might be checked to make it safer.

He said he discussed the idea with pulmonologists and anaesthesiologists, who agreed with its usefulness for patients with short and shallow breathing and might be considered in such a situation.

Dr Mahboob said that he was optimistic that in collaboration with relevant specialists and biomedical engineers, he would succeed in making a simple smart ventilator for less dependent patients.

Published in Dawn, May 15th, 2020