Little Larissa - please read

Banned wrote:Why wouldn't AVAPS with an assured volume be a better alternative for Cheyenne-Stokes respiration than an SV?

Because AVAPS (not prior VAPS) will only change IPAP at a rate of less than 1cm per minute. CSR needs to have individual breaths very quickly and fluidly corrected with individual pressure swings as high as IPAP max.

Banned wrote: And why wouldn't they make an SV with an assured volume

Well, prior VAPS comes much closer to that functional description than gradual AVAPS (the latter limited to those very gradual IPAP deltas at less than 1cm per minute). And I think SV design and scope of application are bound to evolve.

Gradual AVAPS is designed to make slow IPAP adjustments to fix temporary long-haul conditions: 1) temporary or transient acute COPD exacerbations, 2) positional mechanical "overloading" in obesity related hypoventilation, 3) transient or temporary changes in pulmonary-related neuromuscular rigidity or dyscontrol, etc.

Gradual AVAPS changes are intended to address the above changing conditions or sudden "stepped states" in physiology. But those gradual AVAPS changes are not responsive enough on a "per-breath" basis to rapidly address PB, CSR, or other issues that need highly fluid individual breath corrections (those conditions requiring fluid respiratory controller gain compensation).

SWS,

Thanks for all this info on AVAPS & comparison to SV. It is very helpful in appreciating the differences and the design goals.

Re SV, I am doing a lot of thinking about why VpapSV can feel so different from BipapSV when I can set both up with almost identical pressure settings (monitored with a dial manometer). I am pretty sure now, that the most significant difference is the BipapSV having a settable risetime vs the VpapSV doing it automatically. Also am sure the VpapSV has a preshaped wave (shark's fin ?) based on snippets reported about it.

I ask myself why might one way offer advantages over the other & the best I can come up with is that the VpapSV is especially geared to people who need very tight control of their breathing.

Other than that, I am inclined to think that the VpapSV would benefit from an added manual adjustment to the speed/shape of the waveform/risetime.

DSM

Also, I can't yet see a way on my machine to set a fixed BPM rate so agree with your comments & the ambiguity of the available data that I mentioned (actually the presentation says "treats Centrals with a 'timed back-up rate' - auto or fixed" but if we take the words 'timed back-up rate' that is saying that the back-up rate can be set to a fixed number but it is a back-up rate which is of course just that - back-up whereas a Timed only mode is not operating as a back-up. So the actual meaning can be taken as that the machine can be set to S or S/T but not T just as you pointed out.

StillAnotherGuest wrote: I think you should have sent the Synchrony.

No argument.

But it probably would have had to have been an ST. So what is the better BiPAP/VPAP ST? The Respironics BiPAP ST or the ResMed VPAP ST? This is ResMeds VPAP ST:

http://www.resmed.com/en-us/assets/docu ... ng-usa.pdf

Is it as good as the respironics BiPAP ST? The ResMed VPAP ST has duel-impellers, a 'T' Mode, and 'Easy breathe'.

Banned

SAG wrote:LP10 also offers a 100 ml tidal volume. And with those ALTEs and the requirement of continuous nocturnal pressure support, we're already at critical mass.

BTW, it also has a great battery back-up.

In addition to Banned's questions above, I'm also wondering what potentially relevant functionality might be in the LTV 950 (besides flash, which I happen to love) that is not embedded in the LP10.

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DSM, thanks for the thoughts and comments comparing VPAP ASV with BiPAP autoSV. Like you I'm thinking that latter machine just may be better suited for primarily obstructive applications. And maybe we can eventually continue our comparative exploration of those two SV machines in yet other threads. Thanks again.

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My thanks to everyone in this thread.

-SWS wrote:This theory of pathogenesis would be based on the progression of the physiologically-defensive mechanism present during gestation and infancy that protects the airway from fluid aspiration associated with infantile acid reflux and common regurgitation. That physiologically defensive mechanism will conceivably regress in functionality and prominence from gestation to infancy and especially into childhood/adulthood.

Given the nature of the mechanism that you are referring to (especially severity and duration), I think you'd be far more likely to end up with an ALTE than any degree of CSBD.

SAG

-SWS wrote:In addition to Banned's questions above, I'm also wondering what potentially relevant functionality might be in the LTV 950 (besides flash, which I happen to love) that is not embedded in the LP10.

Weight.

SAG

StillAnotherGuest wrote:

-SWS wrote:This theory of pathogenesis would be based on the progression of the physiologically-defensive mechanism present during gestation and infancy that protects the airway from fluid aspiration associated with infantile acid reflux and common regurgitation. That physiologically defensive mechanism will conceivably regress in functionality and prominence from gestation to infancy and especially into childhood/adulthood.

Given the nature of the mechanism that you are referring to (especially severity and duration), I think you'd be far more likely to end up with an ALTE than any degree of CSBD.

SAG

I agree entirely with that probability assessment.

Knowing about the LP10 and its cost is a relief to me. There's a chance that's what the doctor's in Brazil may soon decide Laryssa needs. Much appreciated as always.

Geeze...my memory. I looked this up once before and forgot what it meant. Had to look it up again:

ALTE = apparent life threatening episode

"Sudden infant death syndrome (SIDS) and apparent life threatening episode (ALTE) are considered forms of sleep disordered breathing."
http://www.entnet.org/HealthInformation ... cApnea.cfm

rested gal wrote:Geeze...my memory. I looked this up once before and forgot what it meant. Had to look it up again:

ALTE = apparent life threatening episode

"Sudden infant death syndrome (SIDS) and apparent life threatening episode (ALTE) are considered forms of sleep disordered breathing."
http://www.entnet.org/HealthInformation ... cApnea.cfm

I'm just back from having looked it up myself! And under the same circumstances....

O.

Has anyone priced the PB LP10 unit ?. It looks biggish and one might wonder about the knobs on the front panel (3yo or friends wingin the dials ?).

Am guessing it would be hard to get one of them into the country without a lot of hassles.

DSM

rested gal wrote:Geeze...my memory. I looked this up once before and forgot what it meant. Had to look it up again:

ALTE = apparent life threatening episode

"Sudden infant death syndrome (SIDS) and apparent life threatening episode (ALTE) are considered forms of sleep disordered breathing."
http://www.entnet.org/HealthInformation ... cApnea.cfm

Right. So if the entity proposed by -sws were to occur ("diving reflex"), then you'd either get a "near miss" or a SID.

I suppose you could carry this phenomenon out to adults and say that the bradycardia and vasoconstriction associated with desaturations are some adult manifestions of "diving reflex", but you'd still need something to perpetuate this (increased chemoresponsiveness) and create the hypocapnic central component.

If "diving reflex" began occurring at CSDB frequency, you'd be real lucky to get past "one".

Banned wrote:But it probably would have had to have been an ST. So what is the better BiPAP/VPAP ST? The Respironics BiPAP ST or the ResMed VPAP ST? This is ResMeds VPAP ST:

http://www.resmed.com/en-us/assets/docu ... ng-usa.pdf

Is it as good as the respironics BiPAP ST? The ResMed VPAP ST has duel-impellers, a 'T' Mode, and 'Easy breathe'.

In the ResMed line, the VPAP III ST-A would be the way to go.

SAG

Hi Brazilian,

The http://www.ups.com/ tracking number for the HC406 Seal Kits is 1ZE80A714090161982.

Thanks!
Banned

http://www.cpapauction.com/auction-list ... ifier.html

What does 'Reserve Not Met Yet' mean?

Does it mean no Bid History will be displayed until the 'Reserve' is met?

Banned

Banned wrote:What does 'Reserve Not Met Yet' mean?

From the FAQ: http://www.cpapauction.com/cpap-help/31 ... -mean.html

dsm wrote:Has anyone priced the PB LP10 unit ?. It looks biggish and one might wonder about the knobs on the front panel (3yo or friends wingin the dials ?).

Am guessing it would be hard to get one of them into the country without a lot of hassles.

Priced in the $800 range at auction (used) according to the link SAG kindly provided. However, he didn't provide that link as the ideal machine---only a cost-effective invasive ventilator potentially within financial reach.

I think your other points of consideration are very valid, BTW. If that type of machine is needed it would be nice to get something even nicer IMO. Don't even know if that's a bridge we'll cross based on the doctors' requests.

Hello there,
I'm brazilian, I live in Sao Paulo and this is my first post here.

I've found this forum while googling for information to help me better understand my first ever night study (a split night report that looks and reads like an astronomy book in chinese for me).

Been eating information from here for a couple of days now but digesting it hasnt been easy. It's like discoverying a whole new world of words, equipments, medical terms, people, I am have to admit I feel completely overwhelmed. But also, strangely happy to see I'm not alone in this weird, unknown jorney.

Then, I find myself speechless. Not only I stare at an imense thread (29 pages) about a brazilian little girl suffering from apnea and living in an ICU, but also read a compeling story of a kind-hearted brazilian soul who dares to ask for help on her behalf and finds an army of foreign people ready to bring this little being some hope and lots of love. I am speechless. And so am I grateful of finding this forum and this particular thread. I was very worried about soon to being cpaped, had lots of questions and was anxious on finding the answers. Now I'm just speechless and happy, I'll leave the questions and the answers to another day.

All of you guys deserve cumpliments on being so kind towards this little girl. On joining here to help each other and to help newbies such as myself. Regardless of race, country or language, this thread show us that humanity, more than our clinical condition, is what really bind us together.

See you later.

E Nelson *(brazilian), Dra. Cacau, e todos os outros que nao consigo me lembrar agora, parabens pela atitude.

E para a pequena Larissa: que ela cresca feliz e saudavel, sempre cercada por pessoas como as que cuidam dela na UTI, na enfermaria, aqui nesse forum, etc...