%0 Journal Article
%A Bibiano Guillén, Carlos
%A Arias Arcos, B.
%A Collado Escudero, C.
%A Mir Montero, María
%A Corella Montoya, Fernando
%A Torres Macho, Juan
%A Buendía García, María Jesús
%A Larrainzar Garijo, Ricardo
%T Adapted Diving Mask (ADM) device as respiratory support with oxygen output during COVID-19 pandemic
%D 2021
%U https://hdl.handle.net/20.500.14352/114596
%X At the end of 2019, several cases of pneumonia were identified inWuhan (Hubei, China) [1], caused by a new Orthocoronavirinae, commonlyknown as coronavirus, fromthe Coronaviridae family. In January2020, there was a public health emergency declaration [2] and, as ofMarch 2020, a pandemic [3,4]. At present, more than 2 million caseshave been confirmed globally (2.160.2017 April 18th) [5-9].In Spain, the first spots of epidemiological interestwere identified inMadrid. Some of them were registered in the sanitary region whereboth Hospital Universitario Infanta Leonor and Virgen de la Torre Hospitalsbelong. The first PCR-positive patient was detected on March 4th. Aftertwo weeks, on 18th March, the number of positive cases increased to302, and 41 patients died. By 1st April, one month after the outbreak,the total number of caseswas 1714. These data confirmed the explosiveprogression of the pandemic and the high mortality of patients whowere hospitalized and made it necessary to implement several and differenttherapeutic measures to try and revert the catastrophic progressionof this infection.The most extended therapeutic approach for COVID-19 is based ontwo main strategies [10-13]: pharmacological treatment directed towardseveral physiological targets (viremia, immunological reactions,prothrombotic reactions) and hemodynamic and respiratory supportwith positive end-expiratory pressure (PEEP) in addition to mechanicalventilation. This is vitally necessary until pharmacological treatment orpatient immune responses become effective.China and Italy have already described that acute respiratory distresssyndrome.(ARDS) is the most common manifestation in the clinical course ofCOVID-19 pneumonia [11-14]; however, this syndrome has a differentprogression than other respiratory diseases. The first-choice treatmentfor ARDS is mechanical ventilation (MV) with the use of orotracheal intubation(OTI). The ARDSmortality rate is over 50%, and the delay in thisprocedure is related to an even worse prognosis [15,16].The main limiting factors that healthcare systems must face whenhandling these critical patients are the limited access to ventilatorsand ICU resources and the fact that they are already overwhelmed bymassive hospitalization due to respiratory distress and OTI needs[17,18]. This is why current lines of work are focused on developing respiratorysupport alternatives that will gain time or allow the maintenanceof an acceptable respiratory status until patients can access theICU [19,20]. In the absence of approvedmechanical devices, such as continuouspositive airway pressure (CPAP), positive end-expiratory pressure(PEEP) devices are being used [14,16,21]. In this paper, wedescribe our experience with the adaptation of diving masks (Fig. 1)and predesigned and 3D-printed pieces (Annex) that
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