Best Machine to deal with high Flow Limitations

[StuUnderPressure]

Here is the previous 6-22-17 Recliner FLs when the upper level was at 0.5
http://imgur.com/03n9W3x

And here it is again with the upper level at 1.0
http://imgur.com/fXtPhly

I usually leave defaults as is unless I have a compelling reason to change a default - So, I never "intentionally" changed the upper level from 1.0 to 0.5

Regardless, I am still not understanding why the FLs go up higher when on the upper level of 0.5 and not quite as high when on the upper level of 1.0

[palerider]

the higher the pressure the lower air is available to oxygenation.!

this is simply incorrect. more base pressure = more oxygenation, watch/read ANY tutorial on bilevel ventilation theory and practice.

[Jay Aitchsee]

Here is the previous 6-22-17 Recliner FLs when the upper level was at 0.5
http://imgur.com/03n9W3x

And here it is again with the upper level at 1.0
http://imgur.com/fXtPhly

I usually leave defaults as is unless I have a compelling reason to change a default - So, I never "intentionally" changed the upper level from 1.0 to 0.5

Regardless, I am still not understanding why the FLs go up higher when on the upper level of 0.5 and not quite as high when on the upper level of 1.0

It just a matter of scale. The flow limitations only "look" larger when the Y axis only goes to 0.5 as apposed to 1.0. The lines on the graph represent 0.05 in both cases. The y axis with an upper setting of 0.5 will be 10 lines high. The y axis with a setting of 1.0 will be 20 lines high. A Flow limitation of 0.5 would reach the top of the 0.5 chart but only go halfway up the 1.0 chart. Unfortunately, ResScan doesn't change the little flow limit symbols on the left of the chart (Y Axis) with a change in scale.

In both examples above, your max is 7 lines high, a ResScan measure of 0.35 The problem is we don't know what that means. It is a ResMed number which indicates the degree of Flattening. I suspect it means 35%, but that's only a WAG that seem logical to me. Early discussion of Flow Limitations in this forum suggested a maximum acceptable number to be 0.4, a number taken from ResMed's patent application. But that, too, was a WAG. The only thing that I am relatively sure of is that the pressure will rise with a Flow Limitation of 0.05.

[Guest]

the higher the pressure the lower air is available to oxygenation.!

this is simply incorrect. more base pressure = more oxygenation, watch/read ANY tutorial on bilevel ventilation theory and practice.

I was under the impression that stuunderpressure was currently using an APAP / CPAP device.
I was also generally under the impression: more pressure less tidal volume - and that that is also 1 reason there's a point whre you switch to BIPAP - which than increases that with the higher pressure-support (which results in a higher tidal volume)

If you have anything regarding that where I can read up on that I would really be pleased.

[Jay Aitchsee]

APAP pressure settings on both S9 AutoSets are 13 - 20 with EPR 3

My upper level is already at the Max 20

Sorry, I missed that. I was looking at your EPAP line on your chart.

So then, you have no way to tell whether increased pressure will dampen the Flow Limitations and allow you to feel better, or not, unless you borrow a bi-level or submit to a PSG.

[palerider]

the higher the pressure the lower air is available to oxygenation.!

this is simply incorrect. more base pressure = more oxygenation, watch/read ANY tutorial on bilevel ventilation theory and practice.

I was under the impression that stuunderpressure was currently using an APAP / CPAP device.
I was also generally under the impression: more pressure less tidal volume - and that that is also 1 reason there's a point whre you switch to BIPAP - which than increases that with the higher pressure-support (which results in a higher tidal volume)

If you have anything regarding that where I can read up on that I would really be pleased.

it doesn't matter what stu uses, the principles of ventilation remain.

more pressure does not equate to less tidal volume, and tidal volume is more related to co2 blowoff, not oxygenation.

the main reason for people without other respiratory issues to switch to bilevel is comfort.

you can go looking for bilevel tutorials on youtube.

[Guest]

thank you very much - I totally misunderstand that until now.

[StuUnderPressure]

Here is the previous 6-22-17 Recliner FLs when the upper level was at 0.5
http://imgur.com/03n9W3x

And here it is again with the upper level at 1.0
http://imgur.com/fXtPhly

I usually leave defaults as is unless I have a compelling reason to change a default - So, I never "intentionally" changed the upper level from 1.0 to 0.5

Regardless, I am still not understanding why the FLs go up higher when on the upper level of 0.5 and not quite as high when on the upper level of 1.0

It just a matter of scale. The flow limitations only "look" larger when the Y axis only goes to 0.5 as apposed to 1.0. The lines on the graph represent 0.05 in both cases. The y axis with an upper setting of 0.5 will be 10 lines high. The y axis with a setting of 1.0 will be 20 lines high. A Flow limitation of 0.5 would reach the top of the 0.5 chart but only go halfway up the 1.0 chart. Unfortunately, ResScan doesn't change the little flow limit symbols on the left of the chart (Y Axis) with a change in scale.

In both examples above, your max is 7 lines high, a ResScan measure of 0.35 The problem is we don't know what that means. It is a ResMed number which indicates the degree of Flattening. I suspect it means 35%, but that's only a WAG that seem logical to me. Early discussion of Flow Limitations in this forum suggested a maximum acceptable number to be 0.4, a number taken from ResMed's patent application. But that, too, was a WAG. The only thing that I am relatively sure of is that the pressure will rise with a Flow Limitation of 0.05.

So, I can manipulate the severity of my FLs by merely changing that 1 setting?

Seems like a ResScan defect to me !

[Jay Aitchsee]

So, I can manipulate the severity of my FLs by merely changing that 1 setting?
Seems like a ResScan defect to me !

No, the severity is the same. As I said, the severity of the tallest limitation is 0.35 in both examples. It's only the scale of the graph that is changed, the physical distance between the graduation lines. In one example the scale is 0 to 0.5, and in the other the scale is 0 to 1.0. A limitation of 0.5 would reach the top of 0 to 0.5 graphic, but only reach the middle of the 0 to 1.0 graphic.

The lines on the graphic indicate value. Each line is worth 0.05. Pick a limitation, count the lines to determine the value, change the scale, count the lines again, they will be the same. Even though the representative physical size of the display is changed, the value remain the same. By decreasing the scale, the representative result is physically larger but the value represented is the same.

I do agree that there not being an indication of scale on the chart could be considered a defect. The little picture grams on the Y axis that seem to represent severity do not change with a change in scale as one would expect.

[squid13]

Early discussion of Flow Limitations in this forum suggested a maximum acceptable number to be 0.4, a number taken from ResMed's patent application.

This was a number that was quoted to me also by a forum member as referenced in this thread. viewtopic.php?f=1&t=103098&p=968506#p968506 Jay you had the last comment in that thread.

[StuUnderPressure]

I do agree that there not being an indication of scale on the chart could be considered a defect. The little picture grams on the Y axis that seem to represent severity do not change with a change in scale as one would expect.

And most people would take that to be more severe.

[StuUnderPressure]

Early discussion of Flow Limitations in this forum suggested a maximum acceptable number to be 0.4, a number taken from ResMed's patent application.

Did "I" really say that?

[squid13]

No you didn't, I screwed up and as punishment I'll have only one scoop of ice cream tonight.

[Jay Aitchsee]

I do agree that there not being an indication of scale on the chart could be considered a defect. The little picture grams on the Y axis that seem to represent severity do not change with a change in scale as one would expect.

And most people would take that to be more severe.

Maybe, but then most people probably wouldn't change the scale without purpose to begin with.

Anyway, you could run your results through SleephHead. It has a proper Y axis scale that is annotated and variable.

[palerider]

I do agree that there not being an indication of scale on the chart could be considered a defect. The little picture grams on the Y axis that seem to represent severity do not change with a change in scale as one would expect.

And most people would take that to be more severe.

you seem to be unable to grasp the concept of being able to zoom in on the y axis of a graph, to be able to better view the varying line of data.

it doesn't change the data, or the meaning, just what it looks like.