KINGSTON — With ventilators in short supply during the COVID-19 pandemic, one solution to the shortage can be found in the University of Rhode Island’s Memorial Union ballroom. There, a group of volunteers is cleaning and refurbishing CPAP and BiPAP sleep apnea machines so they can be used as ventilators.  

Dubbed “VentilatorProject.Org,” the initiative, which was launched in mid-April, is a collaboration between the university, the Rhode Island Department of Health, the Rhode Island Commerce Department, fire stations and other hospital and industry partners.

Of the 8.5 million sleep apnea machines in homes in America, industry statistics show that nearly 3 million of them are not in use, and that 9,000 of those are Rhode Island. 

Project leader Alex Hornstein, a Providence businessman and entrepreneur, explained that the idea of using sleep apnea machines as ventilators was born of necessity in New York City, where doctors developed a protocol for their use as ventilators if hospital ventilators were unavailable.

“In this case, the machines themselves are as they are from the factory,” he said. “They’re just repurposed and they’re used off-label, just like a doctor can decide to use drugs off-label,” he said. “In this case, the first doctors I spoke to were Dr. [David] Rapoport, who’s a pulmonologist at Mount Sinai [Hospital] who developed what’s called the Mount Sinai protocol, which is hooking up a light-level BiPAP machine and using that to ventilate an intubated patient. The doctors were in New York and New York was expected to run out of ventilators at the end of a weekend and they wanted to do something. They didn’t want to go into a triage like they’d seen in Italy, so this was a fallback.”

Donated machines can be dropped off at fire stations throughout Rhode Island. They are then brought to URI, where they are refurbished under the direction of associate professor of electrical engineering Tao Wei.

Wei said the machines must be reprogrammed before they can function as ventilators.

“What I did was to look into the possibility of changing the programs of these CPAP and BiPAPs into ventilators,” he said. “So basically, a BiPAP is like a bilevel ventilator, so you only have two levels of pressure … so to make that a ventilator, you have to have the access to the program and change the internal program to basically change the pressure and the function of time as expected.”

One of the challenges, Wei said, was figuring out the program codes for the many brands of machines.

“There’s just a large variety of all kinds of CPAP and BiPAP machines, and that actually imposed some challenges of this part of the work,” he said. “Basically we were working with Alex and his team on this part.”

In addition to the engineering students who are working with Wei on reprogramming the machines, the project has recruited more than 100 student and faculty volunteers to clean and sanitize the used machines.

URI Vice President for Research & Economic Development Peter Snyder said the ventilator project fulfilled one of Gov. Gina Raimondo’s objectives to address Rhode Island’s ventilator shortage.

“In the past 72 hours, I think we’ve converted 300 of them,” he said. “We expect to reach as many as 1,000 more by the end of these next two weeks.”

Snyder said there would likely be more ventilators than Rhode Island can use, and those would be donated to other states and countries that need them.

“We expect to have a surplus,” he said. “At first blush, we will look to neighboring states and address any needs that neighboring states have, and after that, the university maintains wonderful relations with developing countries around the world that may have very critical needs, countries like Senegal, the Philippines, Vietnam.”

Pete Rumsey, director of the Rhode Island Commerce Corporation’s Innovation Campus Initiative and a member of the Rhode Island COVID-19 Working Group, attributed the project’s success to Rhode Island’s innovative spirit.

“We just used a combination of Rhode Island entrepreneurism and toughness, and myself, I focus on innovation and entrepreneurship, so we just thought out-of-box,” he said. "That got me talking to Alex [Hornstein]. He’s tied in with folks down in New York City and out in Colorado and folks in Italy, and from that, I was able to work with him and some other great people and go ‘Wow! We should have a strategy that not only goes after the typical expensive critical care vent [ventilator], but if they can’t deliver in time, we need to have a second and third level of this plan.'”

Hornstein said he felt that it was important for states to support each other through the crisis, and the repurposed ventilators are one way Rhode Island can do that.

“These are our neighboring states,” he said. “We have friends, we have families that live there, and also, they're full of other human beings, and it’s my hope that from seeing the scenario that all states have been in, where they’re competing against one another for scarce resources, it’s not something I like to see, and it’s my hope that there is this idea that repurposing resources that are actually plentiful in our community can turn that narrative into one where we are cooperating with neighboring states rather than competing.”

Information on the project as well as ventilator drop-off locations can be found at https://www.ventilatorproject.org/donate-now.

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