The econonmics of ASV

[VVV]

When those grants are purely academic, philanthropic, or from government, then a good portion of front-end corporate risk is defrayed on those expensive research projects.

I am not sure what you mean by "defrayed" and may have misinterpreted your comment.

However, the fundamental economic laws of risk/benefit cannot be suspended through government or philanthropic financing.

In the case of government the risks and costs are transferred to a broad class of taxpayers (usually the unwitting taxpayers).

In the case of philanthropy it is of course the donors who bear the costs.

In either of these two cases the risk/benefit analysis should be clear to all parties before the investment is made.

Having organized some charitable fund raisers my experience with both large and small donors is they will cough up more money if they are first presented with a clear and credulous risk/benefit analysis.

With governments my experience has been that political favoritism often has more weight than risk/benefit.

[jnk]

Personally, I think the Authorized Standard Version is very economical with its wording.

http://www.acronymattic.com/~/search/aa ... ym=ASV&s=a

I do have a question, though:

What does "econonmics" mean anyway?

[-SWS]

I am not sure what you mean by "defrayed" and may have misinterpreted your comment.

http://dictionary.reference.com/browse/defray

de·fray
   [dih-frey] Show IPA

verb (used with object)
to bear or pay all or part of (the costs, expenses, etc.): The grant helped defray the expenses of the trip.

So modifying the above sentence: "The grant helped defray the cost of research necessary for your life-sustaining machine."

However, the fundamental economic laws of risk/benefit cannot be suspended through government or philanthropic financing.

I think it's worth distinguishing that some of those non-corporate grant (risk) scenarios endeavour to pursue social benefits, whereas ROI groups risk capital specifically toward financial benefit. That's not to say capitalistic investment is devoid of social benefit. But I think the risk/benefit dynamics are different in these two product-development scenarios.

OK, but I don't believe that those two terms based on the acronym ASV (Adaptive Servo Ventilation and Adaptive Support Ventilation) can be used interchangeably. Servo methodology responds extremely quickly and algorithmically strives to undershoot, whereas the minute ventilation-based Support technology is a little slower, and since it's primary concern is keeping patients out of respiratory failure, couldn't care less about overshoot.

Divvy up both functional and nomenclature distinctions as you like. I think your pair of interrelated points are very tenable. I think I even agree with them. I thought some of the initial patent descriptions were using those two interchangeably... But I agree there are differences and PAV entailed greater overshoot and leak intolerance serving as the genesis for ASV.

P.S. Where's Rocklin in all this... Has he risked money toward an ASV investment yet??

[deltadave]

...whereas the minute ventilation-based Support technology is a little slower...

"Little", of course, being relative.

Fiddling with an ASupportV algorithm, it's taking the better part of a minute to fully execute a response to an event. Since a CSA or CompSAS patient has already passed through 1 or 2 cycles during that time, an ASupportV attack would be playing the role of Private Martini (Sal Mineo) in "The Longest Day."

Although upon further reflection, by the time the hyperpneic overshoot came around again, the ASupportV would hit it with a very aggressive attack and substantially compound the problem.

[JohnBFisher]

...whereas the minute ventilation-based Support technology is a little slower...

"Little", of course, being relative.

Fiddling with an ASupportV algorithm, it's taking the better part of a minute to fully execute a response to an event. Since a CSA or CompSAS patient has already passed through 1 or 2 cycles during that time, an ASupportV attack would be playing the role of Private Martini (Sal Mineo) in "The Longest Day."

Although upon further reflection, by the time the hyperpneic overshoot came around again, the ASupportV would hit it with a very aggressive attack and substantially compound the problem.

Exactly!

With the Respironics version (the ASupportV version), I tend to feel a just a little more lethargic and tend to have a little bit of a headache in the morning. While I realize this is very subjective, it is pretty consistent - for me! (And I can not stress enough that this is just my own observation. Your mileage not only may but WILL vary!!!).

Of course, on the flip side is that with the Resmed version (the AServoV version) is that it can be quite disruptive to the normal transition from waking to sleep. The rapid change tends to cause the mask to leak and awaken me as I am drifting asleep.

Ideally, I would like the ASupportV version as I fall asleep or am in a state transition. But once asleep the AServoV version would be a better choice. Though I suspect we will see a unit that can better differentiate sleep states, I don't think we will see it anytime in the near future. But I suspect the manufacturers of xPAP therapy devices are working on adding additional data inputs into the data collection. The industry has changed pretty dramatically over the past 20 years. I see no reason that will not continue into the future.

Thank you, by the way for your excellent educational information. I sure appreciate it. I know others must also appreciate your help.

[jnk]

For any wanting to learn more about Adaptive SUPPORT Ventilation, and other modes used in ventilators, this may (or may not) be helpful . . .

http://www.mecriticalcare.net/downloads ... yModes.pdf

[-SWS]

Since we're discussing nomenclature and the ASV acronym:

autoSV stands for automatic Servo Ventilation.

http://www.healthcare.philips.com/main/ ... sv/faq.wpd

Also Resmed's is the minute volume version and Respironics' is the peak flow version----with both brands varying inspiratory pressure support.

[jnk]

And I don't think this board is the only place with itchy heads:

Three algorithms are available at the moment which are distributed under the terms 'adaptive servo-ventilation', 'auto servo-ventilation' and 'anticyclic modulated ventilation'. However, the term 'adaptive servo-ventilation' is frequently used to describe the principle in general. The devices differ in the target parameters of the regulation, the backup frequency and the applicable pressure levels.

http://www.google.com/url?sa=t&rct=j&q= ... fN6hcjm3Nw

[-SWS]

John, when DeltaDave referred to Adaptive Support Ventilation, he was referring to neither the Resmed Adapt SV nor Respironics Auto SV. He was referring to yet a different implememtation that I linked in error.

I echo your thanks to DeltaDave for educating us! And thanks for your educational links, jnk! Thanks to everyone who comes here to educate and help.

[jnk]

. . . Thanks to everyone who comes here to educate and help.

Just for the record, I consider you preeminently exemplary in that regard, -SWS. It warms my heart to see you posting here a little more. And it's good for my brain, too.

[-SWS]

warms my heart

Well you wouldn't be the first person who accused me of inducing their heartburn...

[deltadave]

John, when DeltaDave referred to Adaptive Support Ventilation, he was referring to neither the Resmed Adapt SV nor Respironics Auto SV.

Right.

ASupportV would be better likened to AVAPS, where volume is varied gradually over a period of time, and certainly not quick enough to respond to SDB events.

A better acronym for ASupportV would be AVAPSESIDTVTRIBIMVO (Average Volume Assured Pressure Support Except Sometimes It Decides To Vary The Rate Instead Because It's Minute Ventilation Oriented).

[JohnBFisher]

... A better acronym for ASupportV would be AVAPSESIDTVTRIBIMVO (Average Volume Assured Pressure Support Except Sometimes It Decides To Vary The Rate Instead Because It's Minute Ventilation Oriented).

Why use a TLA (Three Letter Acronym) when at 19 letter one will do!?!?

[jnk]

warms my heart

Well you wouldn't be the first person who accused me of inducing their heartburn...

Ha!

BTW, thanks for your point earlier about the genesis of ASV. I would assume that it is often the documentation of the limitations of one modality that leads most directly to a recognition of the need for, and ideas for the creation of, a different approach.

[deltadave]

... A better acronym for ASupportV would be AVAPSESIDTVTRIBIMVO (Average Volume Assured Pressure Support Except Sometimes It Decides To Vary The Rate Instead Because It's Minute Ventilation Oriented).

Why use a TLA (Three Letter Acronym) when at 19 letter one will do!?!

OK, how about a pitcher instead?