Repeated Measures Trial of Temporary Automated Manual Ventilation Versus Noninvasive Oxygenation or Conventional Vent

Inclusion Criteria: * Patient may be diagnosed with Covid-19 based on clinical presentation and available laboratory studies including specific Covid-19 testing. * Patient with imminent respiratory failure or status post respiratory failure receiving mechanical ventilation, or requiring mechanical ventilation for airway protection or other cause. * Evidence of no pulmonary disease, or mild to moderate ARDS based on: * fraction of inspired oxygen (FiO2) ≤ 60% with arterial oxygen saturation \> 90% * positive end expiratory pressure (PEEP) ≤ 12 cm H20 * Using an adaptive trial design, the first 10 patients must require mechanical ventilation for reasons other than COVID-19 infection such as airway protection due to overdose, seizure, stroke, or trauma. The next 10 patients may have COVID-19 infection, but must demonstrate lung compliance ≥ 40 ml/cm H2O. If these 10 patients demonstrate a satisfactory course associated with treatment, then the final 10 patients may have lung compliance ≥ 30 ml/cm H2O. Satisfactory treatment course will include, at a minimum: oxygen saturation \> 90%, with PEEP ≤ 12 cm H2O. Exclusion Criteria: * Lack of informed consent from patient, if deemed having capacity, or from surrogate if not * Too medically unstable to participate in study per treating clinician * Patients requiring more than one vasopressor medication for blood pressure support * Age \> 65 years * Clinical evidence of acute coronary syndrome (ACS) including angina, or ECG evide…