dataq1 wrote: ↑Sat Nov 12, 2022 6:38 pm
While awaiting GeneMpls to post your suggested segments….
Can you expand on the elements of the flow curve that are necessary for a “true or real” CSR evaluation?
Look at page 8 of the
Resmed AirSense 11 Clinical manual That page of the Resmed manual includes these figures:
The top figure gives an indication of what
real CSR looks like. Note the rounded shape of the increasing/decreasing parts fo the cycle that are separated by the CAs. The bottom figure includes a breathing pattern that can be called periodic breathing and this kind of breathing
can be flagged as "CSR" by xPAP machines, particularly if the central apnea detection algorithm says those apneas are CAs that separate the breathing parts of the pattern.
That's why looking at a zoomed in part of GeneMpls's breathing pattern that's been labeled as "CSR" would be useful. If the breath by breath pattern looks like the top figure, then there's a much higher probability that the breathing is real CSR. But if the breath by breath pattern looks closer to the second figure, it may be periodic breathing, but it's much less likely to be real CSR breathing.
While the AirSense 11 Auto clinical manual
implies that the machine will distinguish between these two patterns, the fact is that if you zoom in on stuff that gets flagged as CSR on Resmed machines and PB (Periodic Breathing) on PR machines, a heck of a lot of the time the breath by breath breathing pattern looks much closer to the second figure than the first one, particularly if the lowest spots in the respiration pattern are scored as Hs and/or CAs instead of OAs.
And how to distinguish the difference between periodic breathing and CSR? (Not an academic question, wife had a string of a couple of weeks that Resmed classified as CSR, interestingly during that period she switched to her Respironics machine using the same therapy settings, they evaluated her pattern as “periodic breathing”)
It's important to understand that
all CSR is a particular form of periodic breathing (PB). But not all periodic breathing meets the formal criteria of CSR.
And PR (Resprionics) doesn't claim that their machines can distinguish between "periodic breathing" and "CSR". Rather, PR machines label anything (including CSR) that looks like periodic waxing/waning breathing patterns as "Periodic Breathing" or PB. Philips Resprionics expects that if a patient's detailed data is showing significant amounts of PB, the doctor treating the patient should follow up by looking at the actual flow rate data on a breath by breath basis to evaluate whether the breathing pattern is typical of real CSR or is more typical of periodic breathing that is not actually real CSR.
This is a case where PR is being more honest than Resmed is. The fact that Resmed chooses to label things as CSR when it can flag things that are periodic breathing, but not CSR, is misleading at best. And it can lead to patients panicking unnecessarily if there's just a wee bit of breathing flagged as CSR somewhere in their data.
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.
Correct number of posts is 7250 as robysue + what I have as robysue1
Profile pic: Frozen Niagara Falls
. Lefty can afford an Apple puter and doesn't know how real puters work 
