Surprise surprise !

Guest in this instance was me.

DSM

The link to the Bipap titration was very very informative. I have the clinical manual for the PB330 and it does have the titration process in it but I read that in January & was in such a steep learning mode then that the precise steps slipped my focus. I just remembered the bit where it said the gap should be 4 & so I decided to go down (lower epap) instead of up (increase ipap) because that made more sense to me at the time (still does when it comes to comfort ).

D

dsm wrote:I mentioned what I had read about of the Adaptive Servo Ventilation machines. His comment was that has been around in principle for a while & known as PAV (Positive Airway Ventilation).

lubman wrote:I have not heard of Positive Airway Ventilation, but I do find it interesting that both ResMed and Respironics both call it Adaptive Servo Ventilation, which implies that neither own the IP rights to the term.

The acronym PAV, as it relates to ASV (Adaptive Servo Ventilation), refers to Proportional Assist Ventilation, where support to the patient is dependent upon the the forces of resistance (flow) and elastance (volume). A PAV-based machine will supply a set (pro)portion of that effort. And as long as the patient is responsible for at least some of the effort, ventilatory overshoot (with it's problem-causing hypocapnia) may be avoided (as opposed to traditional BiLevel, where it's "ready or not, here comes the pressure, I hope it's not too much!").

The terms ASV (and this is Adaptive Support Ventilation, not to be confused with the ResMed CS-2 machine ASV acronym) and PAV are not interchangeable. When apnea occurs in a patient on ASV, a pre-determined level of support is introduced. When apnea occurs in a patient on PAV, he's got a problem. PAV needs patient effort to work.

Adapt SV, therefore, has components of both of these concepts.
SAG

SAG,

Many thanks for that further clarification.

My Doctor also made the comment re ASV that it was leak intolerant and we discussed then that this meant new better masks were required to get around that problem.


DSM

DSM AND OTHERS WHO HAVE CONTRIBUTED TO THIS SUBJECT:

THANK YOU!

I too am finding that the more I learn, the more there is to learn!

This has been most interesting and revealing; I'm looking forward to more of same. So good to have around those of you who are capable of doing this reasearch for us - and passing it on.

DSM - You and your doctor sound like a good match! You must keep him on his toes!
There are just TOO MANY doctors here that practice "cookie cutting". Your investigations may help us to help them change that, with any luck.

birdshell wrote:Amen, Offerocker. It is amazing to realize the high level of expertise of our Forum Folk.

We are so fortunate!

This is my "Link to reality - as I would like it!"

...this place (with few exceptions) is my verification that there is "hope for humanity" yet, and where there is mutual trust and support, after experiencing some really weird/annoying happenings in daily life.

...well, for DSM: I must get back to 'business' NOW!