As infections from the ongoing COVID-19 pandemic continue to climb, hospitals around the world are struggling with a fatal shortage of ventilators, the bedside devices that help patients breathe when they can’t. so himself. Meanwhile, hundreds of thousands of small breathing machines known as positive airway pressure machines sit idle in closets or warehouses because their manufacturers say they can’t perform the same life-saving functions.
Security researcher Trammell Hudson analyzed the AirSense 10— the most popular CPAP in the world — and made a surprising discovery. Although its manufacturer says that AirSense 10 will require “necessary adjustment to work as a ventilator,” many Breathing functions are already built into the device’s firmware.
Its manufacturer, ResMed, says the $700 device works only as a continuous positive airway pressure device used to treat sleep apnea. It does this by blowing air into the mask. ResMed says the device can’t work like a bilevel positive pressure oxygen machine, which is a more advanced machine that draws air into the mask and then reduces the pressure to a minimum level to allow it to return. With no ability to work in both directions or increase output when needed, the AirSense 10 cannot be used as a ventilator that can help patients struggling to breathe. After modifying the firmware, Hudson said ResMed’s claim was simply not true.
To demonstrate its findings, Hudson on Tuesday is releasing a patch that it claims unlocks hidden capabilities buried deep within AirSense 10. The patch is dubbed Air in tribute to jailbreaks used by hobbyists to remove technical barriers Apple Developers stuck inside iPhones and iPads. While jailbreaks open functions that allow installation of unauthorized applications and access to log files and forensic data, Airbreak allows AirSense 10 to work as a bilevel positive airway pressure device, a device that many people refer to and as a BiPAP.
“Our changes bring the AirSense S10 closer to features with BiPAP devices from the same manufacturer, increase the available maximum pressure, and provide a starting point to add more emergency ventilation functionality,” Hudson and other researchers wrote on them. website showing the findings.
Bilevel positive airway pressure devices are not normally approved to treat patients suffering from COVID-19, but in the ongoing emergency facing many hospitals, the Food and Drug Administration has some time. approve their use as ventilators, provided the converters are fitted with filters to prevent aerosolization of the virus. Several groups are actively working to let the change happen. The acquisition of hundreds of thousands of low-cost CPAP machines could give those efforts a major boost.
The researchers are clear that Airbreak should not be used on any device treating a patient suffering from COVID-19—at least not yet. A more immediate use is to confirm that AirSense 10 does, in fact, have the ability to provide emergency ventilation services. The researchers’ preference is for ResMed to release its own firmware update that unlocks ventilator functions. Given the recent FDA clearances, ResMed could do this very quickly, the researchers said.
The benefit of the ResMed release patch is twofold. One, updating a manufacturer’s release is likely to be more reliable. In addition, the patch from ResMed can be installed very quickly and reliably on more recent devices that have air update capabilities. Installing Airbreak, by contrast, is a lengthy process that requires manual case opening and flashing firmware.
ResMed representative Tracy Moehnke, however, said that neither the AirSense 10 nor the more advanced AirSense 10 AutoSet is capable of providing “bilevel therapy,” meaning both inhalation and exhalation. The less expensive AirCurve 10 device can do that, Moehnke said. When I asked about the major modification that the company says is needed to make the less expensive AirSense 10 models work this way, Moehnke replied, “Only CPAP- and APAP-devices will need major modification to deliver bilevel therapy do.”
Asked if ResMed is willing to work with researchers to explore ways to modify low-cost models, the representative wrote, “We are already exploring that option, but our primary focus is to increase the production of our current ventilators, the mask, and accessories.”
Tuesday’s release of Airbreak will allow medical technicians and researchers to test unannounced versions of ResMed’s devices to see exactly how they might be used in emergency rooms struggling with the devices’ lack of risk. good breath. It is also designed to show that little is preventing first responders from using the AirSense 10 — and possibly CPAPs available from ResMed’s competitors — to treat patients suffering from COVID-19.
Submit an update to better describe bilevel positive airway pressure devices.