what keeps the airway open on expiration?

[raisedfist]

On a ventilator you can turn off EPAP if you are using an active circuit with an exhalation valve. EPAP is not an absolute requirement for positive pressure ventilation. A person with a neuromuscular disease could use a Trilogy 100 with an active circuit, non-vented mask, using an IPAP of 18 and an EPAP of 0 just fine, should they not have OSA. If no OSA, no collapse of airway, EPAP or not. On a passive circuit you must have EPAP because the expired air must go somewhere, thus the reason for using a vented mask.

On older bi-level machines the EPAP used to go all the way down to 2cm h2o. Now the lowest I've ever seen is 3.

[palerider]

On a ventilator you can turn off EPAP if you are using an active circuit with an exhalation valve. EPAP is not an absolute requirement for positive pressure ventilation. A person with a neuromuscular disease could use a Trilogy 100 with an active circuit, non-vented mask, using an IPAP of 18 and an EPAP of 0 just fine, should they not have OSA. If no OSA, no collapse of airway, EPAP or not. On a passive circuit you must have EPAP because the expired air must go somewhere, thus the reason for using a vented mask.

On older bi-level machines the EPAP used to go all the way down to 2cm h2o. Now the lowest I've ever seen is 3.

Well yeah... ventilators, you can do a lot of things.

[jimbud]

This is what the OP had when the OP asked question:

Post by tyrinryan » Thu Jul 04, 2019 9:17 am

Machine: AirSense™ 10 AutoSet™ For Her CPAP Machine with HumidAir™ Heated Humidifier

Not a ventilator.
JPB

[raisedfist]

party pooper

[jimbud]

party pooper

Apologies.
It had all turned to a general discussion anyway.
JPB

[HoseCrusher]

Just to present an alternative perspective...

This is extremely difficult to do so if you are frail don't attempt this.

We normally consider chest expansion and drawing air in as inhalation. Everything relaxes and air goes out during exhalation. Some breathing exercises focus on forcing more air out than what is involved in normal expiration.

If you cycle between forcing air out, then relaxing to draw air in you end up with somewhat of a reverse cycle. Effort to blow air out and relax to breathe in.

This is totally not natural and I don't think you can do it in your sleep, but it is fun to play with breathing. I can only do this for a very short period of time. I find it interesting to observe that either way of breathing, normal or reversed, while awake has no change on my O2 levels as long as I am resting and not engaged in any activity.

[jimbud]

Just to present an alternative perspective...

This is extremely difficult to do so if you are frail don't attempt this.

We normally consider chest expansion and drawing air in as inhalation. Everything relaxes and air goes out during exhalation. Some breathing exercises focus on forcing more air out than what is involved in normal expiration.

If you cycle between forcing air out, then relaxing to draw air in you end up with somewhat of a reverse cycle. Effort to blow air out and relax to breathe in.

This is totally not natural and I don't think you can do it in your sleep, but it is fun to play with breathing. I can only do this for a very short period of time. I find it interesting to observe that either way of breathing, normal or reversed, while awake has no change on my O2 levels as long as I am resting and not engaged in any activity.

If you don't mind I would like to use that in my rotation of party games.
Ring Around the Rosie, Spin the Bottle, Twister and then the coup de gras, Lets All Breath in Reverse(it will slay).
Man, Hosecrusher you are one "wild and crazy guy".
You can think up some stuff for sure.
JPB

[katestyles]

Some thoughts.

1) I play brass instruments. I have spent years training my exhalation to be controlled in both speed and intensity. So that I can play my instrument. Breathing in needs to be swift, and breathing out needs to be significantly slower.
2) In Yoga there is this thing called "square breathing" when you breathe in to a count of, say 4, hold the breath for the same count, breathe out over the same count, and then hold your lungs empty for the same count. I like it. I find that breathing in is more "reflexive" when I am starved of oxygen, and it does not feel like I am working to draw in the air, rather, I am relaxing to allow the air in.
3) My Alexander technique teacher has also taught me to expel ALL the air from my lungs, then wait (which requires muscle action) until I must (reflexively) draw in air.

I think that we all know that muscles come in pairs, and simply relaxing a muscle does not cause a limb to move. It is the contraction of another muscle that causes the movement. If the diaphragm relaxes, gravity will pull the ribcage down, but the intercostal muscles are likely also active.

[zonker]

Some thoughts.

hey, there! where you been?

to OP: sorry, i'm just happy to see kate back again.

[Jas_williams]

On a ventilator you can turn off EPAP if you are using an active circuit with an exhalation valve. EPAP is not an absolute requirement for positive pressure ventilation. A person with a neuromuscular disease could use a Trilogy 100 with an active circuit, non-vented mask, using an IPAP of 18 and an EPAP of 0 just fine, should they not have OSA. If no OSA, no collapse of airway, EPAP or not. On a passive circuit you must have EPAP because the expired air must go somewhere, thus the reason for using a vented mask.

On older bi-level machines the EPAP used to go all the way down to 2cm h2o. Now the lowest I've ever seen is 3.

Well yeah... ventilators, you can do a lot of things.

Sure they can and are a specialist piece of medical equipment to treat many things and not just Obstructive Sleep Apnoea

[Jay Aitchsee]

I think that we all know that muscles come in pairs, and simply relaxing a muscle does not cause a limb to move. It is the contraction of another muscle that causes the movement. If the diaphragm relaxes, gravity will pull the ribcage down, but the intercostal muscles are likely also active.

Don't forget we have atmospheric pressure also playing a part.
It might be helpful to remember that atmospheric pressure at sea level is 14.7 PSI = 29.92 inHg = 1033.5 cmH2O
And 10cmH20 equals approx 0.142PSI

[zonker]

I think that we all know that muscles come in pairs, and simply relaxing a muscle does not cause a limb to move. It is the contraction of another muscle that causes the movement. If the diaphragm relaxes, gravity will pull the ribcage down, but the intercostal muscles are likely also active.

Don't forget we have atmospheric pressure also playing a part.
It might be helpful to remember that atmospheric pressure at sea level is 14.7 PSI = 29.92 inHg = 1033.5 cmH2O
And 10cmH20 equals approx 0.142PSI

i was told there'd be no math!

[palerider]

I think that we all know that muscles come in pairs, and simply relaxing a muscle does not cause a limb to move. It is the contraction of another muscle that causes the movement. If the diaphragm relaxes, gravity will pull the ribcage down, but the intercostal muscles are likely also active.

Don't forget we have atmospheric pressure also playing a part.
It might be helpful to remember that atmospheric pressure at sea level is 14.7 PSI = 29.92 inHg = 1033.5 cmH2O
And 10cmH20 equals approx 0.142PSI

i was told there'd be no math!

Looks like you were lied to.

[ChicagoGranny]

1.jpg

[Goofproof]

1.jpg

When it comes to Hershey, it always comes down to the Math. The Corps all depend on you not being able to do it. A may not use Algebra, but. I can figure out the lowest cost per Oz, for my Fix! Jim