Help! Hubby's settings failed him, stop breathing short time

Morbius wrote:So I have a question.

How the heck did Total Leak get to ~56 LPM?

No mask does that, even at 14.0 cmH2O:

http://www.healthcare.philips.com/pwc_h ... 111027.pdf

small child profile light... but seriously folks, 30 something intentional and 20something excess... no good, but not horrible, no?

From ~20 the day before? With 1.0 cmH2O additional pressure?

He wears a chin strap but I note he has his mouth open just a tiny bit but the machine has never shown big leak so I thought it was okay,

Morbius wrote:From ~20 the day before? With 1.0 cmH2O additional pressure?

most of the night looks like the worst of the night before, and the periods of very low flow variation coincide with the highest of leak...

machine having problems registering flow variation when the leak's that bad, perhaps?

I don't understand the question. Would you restate what you have told me? I really want to understand how to help him. Thanks so much for looking at this.

Just to avoid the confusion of multiple threads -- this discussion has moved to a new thread: viewtopic/t106001/Morbius-would-you-take-a-look.html

palerider wrote:most of the night looks like the worst of the night before, and the periods of very low flow variation coincide with the highest of leak...

machine having problems registering flow variation when the leak's that bad, perhaps?

"IMHO", and overall, the Patient Leak is OK. The Total Leak is what appears to be screwy:





AAMOF, the worst leaks (which still aren't horrible) do not exhibit the Low Flow Behavior.

If you want, upload the whole file to Dropbox, and breath-by-breath research can be used to try to figure out what the issue is.

Morbius wrote:With 1.0 cmH2O additional pressure?

Actually, the pressure increase was 1.5 cmH2O, but that should have increased Intentional Leak by only ~2 LPM.

Morbius wrote:

palerider wrote:most of the night looks like the worst of the night before, and the periods of very low flow variation coincide with the highest of leak...

machine having problems registering flow variation when the leak's that bad, perhaps?

"IMHO", and overall, the Patient Leak is OK. The Total Leak is what appears to be screwy:

it might be important to note that the total leak is the only data reported from that machine, the 'patient leak' is a sleepyhead calculated value, and it has no sanity checking in this version, if you have an added unintentional leak it won't show up in the 'leak' line. SH takes the total leak and does math stuff to calculate a baseline. but if you never get a decent seal, it won't be able to compute a valid baseline. I've had discussions with jedimark about adding in some sanity checks, but those haven't been included yet as of the 098-1 version. therefore it's best not to put a lot of stock in the 'leak' line on a respironics machine trace.

palerider wrote:...the 'patient leak' is a sleepyhead calculated value...

We can figure that out manually by finding out is what mask was being used and calculate it using the previously posted reference chart. Also noting any mask changes. That 56 LPM looks stable, and if you subtract the ~35 LPM of typical Intentional Leak, the remaining 21 LPM is not particular toxic (ResMed gives you to 24 LPM).

Consequently, one still must believe that the low flow rates are accurate....

...but obviously need to determine if they require emergency intervention or if they are benign (and clearly you don't want to guess wrong).

Anyway, another explanation could be a dramatic decrease in Dead Space. If the Dead Space zones are flushed, then the Tidal Volume will also decrease as breathing becomes highly efficient...

...and although data is limited, Low Flow Behavior is predictable. When there is a stable Unintentional Leak of ~21 LPM, LFB appears:

But just in case somebody is thinking "Wow, what a great idea, I'm going to invent a system that shoots oxygen in at 60 LPM and do wonderful things!", don't bother, you're too late:

http://www.rtmagazine.com/2013/09/high- ... ifference/

Morbius wrote:...and although data is limited, Low Flow Behavior is predictable. When there is a stable Unintentional Leak of ~21 LPM, LFB appears:

that's what I'd noticed, but as to what it means, your guess is far better than mine.