A simple system developed over several years makes it possible to use non-invasive ventilation for many patients infected with the coronavirus. Less intubation means fewer busy machines and less care from medical personnel.
- The “Boussignac system” is a non-invasive respiratory assistance
- Its use could free up machines and personnel in intensive care units
The coronavirus epidemic that is sweeping our country is responsible in 15 to 20% of cases of hypoxemic pneumonitis which requires, for about 5% of patients (depending on age), prolonged intubation with initiation of artificial respiration.
This step is critical for our country where the artificial respiration machines available are not in sufficient number in the context of this brutal epidemic. Intubation is also a problem because of the significant care required to put in an artificial coma to support ventilation and the risk of bacterial infections which is added as soon as a patient is intubated.
However, a French invention, already old and still available, which makes it possible to use non-invasive ventilation in this case, could constitute a simple alternative for many patients.
A simple NIV system
The Boussignac system is a non-invasive respiratory assistance (CPAP) device that delivers a constant level of pressure in the airways and works without electricity and without an artificial ventilator. It can therefore be particularly useful in the current epidemic context where resuscitators are managing the shortage.
The system is based on the use of a non-invasive ventilation mask with its harness and an oxygen flow meter allowing a flow rate of up to 15 liters per minute, ideally up to 20 liters per minute.
Any non-invasive ventilation mask can be used, except masks equipped with an intentional leak system, to avoid contamination of personnel. This system must be equipped with a heat and humidity exchanger filter, the purpose of which is to limit the risk of contamination of caregivers.
Easy to use
The installation of this system is quite simple and is perfectly described in a video carried out by the Assistance Publique with the resuscitation team of the CHU Henri-Mondor (Val-de-Marne). Different experts contacted confirm that, without replacing all the indications for intubation, the use of this system could make it possible to reduce the use of it in complete safety for patients and caregivers.
This non-invasive ventilation system effectively protects caregivers from contamination, does not require electricity and can be used as soon as the first clinical signs of respiratory difficulty requiring hospitalization are discovered.
The high pressure oxygen flow can be adapted to the evolution of the disease without changing the equipment: it is enough to adjust the oxygen flow and the pressure in the respiratory tract, according to the clinical signs and the saturation in oxygen.
This would potentially be a great simplification of treatment in intensive care and a saving in respirators and personnel. Several Parisian hospitals have ordered significant quantities and the health authorities are taking a close interest in this system.
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