Post
by palerider » Fri Sep 17, 2021 1:59 pm
So, yes, the minimum pressure is too low (it's effectively 8, due to EPR), and you see where the pressure gets down, then he starts having apneas, the pressure goes up but he keeps having clusters, likely until he's awake enough to move around or something and get them stopped.
Raising the base pressure, either through raising the Min pressure, or decreasing EPR (or both) will likely alleviate that, he may only need a couple more cms of base pressure to get things more under control, and if we can control the initial apneas, that might prevent the clusters, and will keep the machine from needing to go up as much in the first place.
Pugsy and I agree (we agree on most suggestions about improving therapy) that decreasing the EPR *may* cut down on the centrals, the overall number isn't too worrying, but the extended clusters of them can result in oxygen desaturations, but dropping EPR is an easy thing to try. The reason that EPR can cause problems is that the more of a difference between the inhale pressure and exhale pressure, the more it ventilates the user, and the more ventilation, (the greater Tidal Volume, ie, the volume of each breath) the more CO2 is blown off. CO2 is what drives the desire/need of your body to breathe, and if you blow off too much, your body just won't feel any need to breathe for a number of seconds, and sometimes that's long enough for the machine to flag a central apnea. Centrals aren't worrying unless there's a bunch of them in a row, they're not stressful like obstructives are, where he's fighting to try and breathe.
If you could right click on the vertical "Flow Rate" words on the chart, then select X-Axis, pick 'override' and set the numbers from -60 to 60, it'll make those zoomed in screenshots much more meaningful.
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