Re: Pressure and the heart - any truth to this?
Posted: Thu Sep 08, 2022 3:36 pm
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There's NO indication that the OP has a machine capable of going over 20 cm/H2O, considering he was prescribed a fixed pressure of 12. CPAP and APAP machines do not go over 20 cm/H20. Nor is there any evidence that the OP has any signs or symptoms that would raise the concern. And even if the incidence doubles for people prescribed a PAP capable of higher pressures, it is still going to be exceedingly rare.Cool, but my point is that the group becomes significantly higher at CPAP >25 cmH2O.
(Emphasis added).After an extensive review of literature, we found only 4 other cases of PTX occurring with the use of NPPV for OSA
Seriously-- do you have a learning disability?
That's completely irrelevant under any part of this discussion, even if we use your misinterpretation of what I said, because:Janknitz wrote: ↑Thu Sep 08, 2022 4:33 pm(Emphasis added).After an extensive review of literature, we found only 4 other cases of PTX occurring with the use of NPPV for OSA
https://www.ncbi.nlm.nih.gov/pmc/articl ... 0is%20rare.
The literature cited in that article finding four cases spanned 22 years, from 1998 to 2020. And only one of those cases showed no underlying lung disease.
if you have blebs I can guarantee you you'll get a pnx in about 2 breaths.
It wasn't a doctor it wasbabydinosnoreless wrote: ↑Thu Sep 08, 2022 8:27 amPersonally I would dump the doctor and get a second opinion.
Does anybody read anything?an AP-RN who works for the large medical practice that operates the center.
Well, that original discussion point included all complications for the entireJanknitz wrote: ↑Thu Sep 08, 2022 4:33 pmNor is there any evidence that the OP has any signs or symptoms that would raise the concern. And even if the incidence doubles for people prescribed a PAP capable of higher pressures, it is still going to be exceedingly rare.Cool, but my point is that the group becomes significantly higher at CPAP >25 cmH2O.
(Emphasis added).After an extensive review of literature, we found only 4 other cases of PTX occurring with the use of NPPV for OSA
The literature cited in that article finding four cases spanned 22 years, from 1998 to 2020. And only one of those cases showed no underlying lung disease.
but we can talk more on pnx if you want.subset of people for whom too much pressure can present a danger.
I can answer that question.....and my thoughts are "no, not really and/or they often misinterpret what someone says when they do"...but my gut response is "rarely". Hence the gazillion questions we see here every day and it's an extreme rarity that we ever see a totally new question.
and your response wasI've done quite a bit of reading about CPAP, and I've never come across that claim. Is there any truth to it?
Which tells me that it's not that much of a risk until people start hitting 25 cm pressure and apap/cpap can't go that high and the number of machines that will go above 25 is really, really small.Once you start hitting about 25 cmH2O.
Very high pressures start to impinge upon the capillary bed, and blood starts to back up behind right heart and accumulate in the periphery.
Duh....those are some rather serious problems that I just imagine if someone were to fall in those categories it wouldn't come as a total surprise to the patient and/or the medical care team involved.....and if it did someone isn't doing their job very well.Contraindications
Positive airway pressure therapy may be contraindicated in some patients with the following pre-
existing conditions:
severe bullous lung disease
pneumothorax
pathologically low blood pressure
dehydration
cerebrospinal fluid leak, recent cranial surgery, or trauma.
Same difference. Same advise. Get a second opinion. Doctors /nurses or whatever letters they have after their names they are all practicing. If you don't like what they have to say and you don't want to take medical advise from some random dude on the internet get a second opinion. Myself, I trust the random internet person over the doctors but thats my own hang up. You do you.Rubicon wrote: ↑Fri Sep 09, 2022 2:08 amIt wasn't a doctor it wasbabydinosnoreless wrote: ↑Thu Sep 08, 2022 8:27 amPersonally I would dump the doctor and get a second opinion.
Does anybody read anything?an AP-RN who works for the large medical practice that operates the center.
Congratulations!babydinosnoreless wrote: ↑Fri Sep 09, 2022 8:56 amI trust the random internet person over the doctors
Pr is one of the random internet people that helped me to get my own settings right when the doctors did not. He and pugsy have more pap related knowledge than any doctor I've ever met and I highly recommend them both as good resources for pap.Rubicon wrote: ↑Fri Sep 09, 2022 9:17 amCongratulations!babydinosnoreless wrote: ↑Fri Sep 09, 2022 8:56 amI trust the random internet person over the doctors
With that comment you've earned Spot #1 on the (a) PR Beware List!