Bipap problems

[Sludge]

... this thing is about as helpful as a rock.

OK, a rock that can give big pressures.

And a very expensive rock.

[robysue]

However, if you're treating OSA/CSA etc., note the absence of virtually anything that would be useful, so for sleep apnea, this thing is about as helpful as a rock.

Asking for clarification: What things ARE useful for treating Sleep Apnea?

Is the problem that the VPAP™ COPD doesn't record data or is there something I'm missing???

[mikebrant97]

So it's not the machine I need? ?????

[mikebrant97]

I think I just wish I could live in in hyperbaric chamber. It would be simpler I think. N easier to put the mask on

[Sludge]

So it's not the machine I need? ?????

I sincerely doubt it (it lacks any ability for auto options). Using NIV technology is the same as the 1985 approach to OSA.

Can you get the results of your titration and upload the data from the machine?

Lower esophageal sphincter pressure at the esophageal-gastric junction (the thing that creates the seal that prevents regurgitation) is ~ 20–25 cmH2O. If your BiPAP attack is 30/23 there's always going to be great risk for gastric insufflation, so you're going to need a plan to manage that. Do some stuff to prevent that (jack up the head of the bed, avoid large meals, etc.) but "IMHO" you should look for opportunities to reduce mean pressure where possible (that said, if you're on 30/23 you must be BAAAAADDDDD, so arbitrarily reducing would probably not be a good idea).

However, those pressures may only be necessary in specific situations, like supine REM, so positional therapy plus AutoBiPAP

http://www.healthcare.philips.com/pwc_h ... tfinal.pdf

might be a valid approach (that thing not only has high pressure capability but PS = 0. More on that later).

Also get rid of some LBs. I think that would really go a long way in pressure reduction > better treatment efficiency > better compliance > more weight reduction > better treatment efficiency...

[Sludge]

I think I just wish I could live in in hyperbaric chamber.

So let's think about that. The obstructions would continue, and the arousal mechanism would be dampened by the supranormal oxygen levels (there'd still be a little breathing), but lactic acidosis would be greatly reduced cause your pO2 is like 1200 mmHg...

OK, let's do it!

If you can get $133,000 for the tube, I can I torrent the clinical manual.

Major dial wingin"!

[Sludge]

Also, if we go to a real OSA/CSA machine, we can get some of that BiFlex going to help immediately reduce Mean Pressure.

[Sludge]

Can you get the results of your titration...

Because another opportunity may be hiding in "hysteresis":

4.3.2.9 “Down” titration is not required but may be considered as an option (Consensus).

This recommendation and the following protocol is based on consensus agreement by the PAP Titration Task Force. As in the case of CPAP, a “down” titration is recommended for BPAP due to the “hysteresis” phenomenon (see Recommendation 4.2.2.8). If a “down” titration is implemented, the Task Force recommends at least one “up-down” BPAP titration (1 cycle) should be conducted during the night. “Down” titration of IPAP and EPAP is conducted when at least 30 min has elapsed without obstructive respiratory events. IPAP should be decreased by at least 1 cm H2O with an interval no shorter than 10 min, until there is reemergence of obstructive respiratory events. There is also limited evidence that an “up-down-up” titration protocol should be considered for CPAP (see Recommendation 4.2.2.8); an “up-down-up” titration protocol should also be similarly considered for BPAP.

[mikebrant97]

It sends data via a modem that Ic cellular. I'm am trying to lose weight

[Sludge]

Right, they're using EasyCare Online:

ResMed’s EasyCare Online therapy monitoring is a comprehensive solution that empowers you to help patients achieve better therapy outcomes and manage their condition post-discharge.

• Usage reports make it easy to identify patients who are not following their treatment plan so you can proactively address issues.
• Critical respiratory parameters provide additional insight into patient therapy:

• • Respiratory rate
  • Tidal volume
  • Minute ventilation
  • I:E ratio

Try shoving an SD20 Card in there to see what happens.

Do you have a real computer with an SD20 card reader?

[mikebrant97]

Yes I do but wouldn't it take special program to use the card for its information

[Sludge]

Yes I do but wouldn't it take special program to use the card for its information

Yes, but you can get it (them) here or simply upload ALL the files on the SD20 card to Dropbox, where nosy users (like me) can view the data.

[DoriC]

Mike, in case you're not aware yet, you're lucky to have Sludge on your case!

[mikebrant97]

Ok I'll check it out in the morning. I just got home I'm glad. I just hope this thing is figured out soon n possibly y it makes my lungs ache

[mikebrant97]

hi guys i jsut got home i downloaded the data how do i post it to you sir