シュノーケルマスクを人工呼吸器に改造、患者増加で緊急対応

【ブリュッセルＡＦＰ＝時事】
呼吸困難に苦しむ新型コロナウイルス感染症（COVID-19）患者の増加に病院が直面する中、症状の悪化を食い止めようと、創造性豊かな医療従事者らがスポーツ用品店のシュノーケルマスクに注目している。（写真はベルギー・ブリュッセルのエラスム病院で、3Dプリンターで作成した呼吸弁が付けられたシュノーケリングマスクを試用する医療関係者）
　このアイデアに最初に着手したのは、欧州で最も新型コロナウイルスのパンデミック（世界的な大流行）による被害を受けたイタリアだ。他国の病院もこれに注目し、機能性向上のため別の医療機器を付け加えるなど工夫を凝らしている。
　ベルギーの首都ブリュッセル郊外にあるエラスム病院もその一つだ。同院の呼吸理学療法士、フレデリック・ボニエ氏は「重度の呼吸器障害のある患者に使用される予定だ。患者の気管に挿管し、人工呼吸器を装着するのを避けることが目的だ」と説明した。
　ボニエ氏は、顔全面を覆うマスクの上部にフィットするようカスタムメイドした呼吸弁の設計を指揮。この部分にシュノーケルが装着され、人工呼吸器「ＢｉＰＡＰ」につないで空気を送り込む仕組みだ。
　新型コロナウイルス感染者は最悪の場合、集中治療室で人工呼吸器を装着しなければならない。しかし患者の急増に伴い、人工呼吸器は世界中で深刻な在庫不足となっている。
　ボニエ氏は、３０日からシュノーケルマスク５０個を患者に試す予定だと述べている。
　仏スポーツ用品小売り「デカトロン」は、シュノーケルマスクが緊急的に使用されていることに「関心」を示した一方、公式ツイッターアカウントに「こうした解決策が実際に機能するのか、現時点では確認できていない」と投稿し、慎重な態度を見せている。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/03/31-13:05）

As hospitals face an overload of COVID-19 patients struggling to breathe, innovative medical staff are turning to snorkelling masks from sports stores to stop their lungs collapsing.
The idea started in Italy, the European country worst-hit by the coronavirus pandemic, with hospitals in other nations taking note and adding their own specific medical parts to make it work.
One such is the Erasme Hospital on the outskirts of Belgium's capital Brussels. It is attached to the city's ULB university -- and through it to a private spin-off, Endo Tools Therapeutics, whose knowhow in 3D printing for medical use has proved invaluable.
They are to be used for patients with severe respiratory problems. The aim is to avoid having to intubate the trachea of the patient and put them on a respirator, said Frederic Bonnier, a respiratory physiotherapist at the hospital who also teaches at the university.
He spearheaded the design of a custom-made valve that fits to the top of full-face masks, where the snorkel is meant to go, allowing them to connect to standard BiPAP machines that feed pressurised air into masks.
This helps prevent the collapse of alveoli, lung air sacs needed for the intake of oxygen into our bodies and the exhalation of carbon dioxide. Pneumonia brought on by COVID-19 inflames the lung membrane and fills those sacs with liquid.
- Stop-gap solution -
In the worst-case infections, patients have to be hooked up to respirators in intensive-care units.
But respirators are in desperately short supply worldwide because of the sheer number of patients.
The snorkelling mask solution could be a stop-gap measure for patients on the brink of intensive-care treatment but for whom no beds nor respirators are available. Hospital masks for the less-intensive BiPAP (bilevel positive airway pressure) machines are also lacking.
Bonnier said that from Monday he will testing 50 of the masks on patients.
They are the same brand as those used by Italian doctors, donated by the French sportswear retailer Decathlon that has stores worldwide. The masks themselves are made in Italy.
He explained they were far more comfortable than the hospital ones that fit over the nose and mouth, biting into the skin. But he cautioned they were not tested to medical standards, meaning they were one-use only, unable to be sterilised between patients.
The Italian design for the 3D-printed valve also needed reworking.
It seemed fairly complicated to make, pretty heavy, not very comfortable. So we had the idea to go a little further by thinking on it and developing our own connection part, he said.
The new plastic valve connectors have now been 3D-printed and are ready to be tested.
Bonnier added that health workers in COVID-19 wards could also use the masks for protection against the virus. But he fears the public will start panic-buying them, thereby depriving hospitals of a potentially life-saving product.
He also said that, even if the tests prove conclusive, there were still questions about how many such masks could be made available by sporting companies, under what conditions.
- Retailer cautious -
Learning of the emergency use being made of its snorkelling masks, Decathlon expressed interest -- but also prudence.
At the moment we don't have confirmation that these solutions really work, it said on its Twitter account.
If we see successful try-outs, and these hospitals confirm to us that some tests work, then we'll keep you informed. But in the meantime, beware of unsourced and unverified information spread on social media in recent days.