OK, but that "snip" you quoted is from what I interpreted to be from a document authored by: azuresky73( 185) and was not from Wendy, herself.wlo2008 wrote:Thought it was intresting on why they don't like us to change the pressure our selves. Refering to If you lower it too much, you're not providing enough pressure to fix apneic episodes. If you raise it too high, you run a risk of having pressure-induced central apneas PLUS having an adverse effect on intrathoracic pressure and venous blood return. It's not that the information is a secret protected by an esoteric society, it's that willfully providing this info can easily be made a legal issue as far as liability of the DME for example
CPAP/Bipap Provider Manuals--THE TRUTH
by: azuresky73( 185)
73 out of 88 people found this guide helpful.
Guide viewed: 4899 times Tags: cpap | bipap | respironics | resmed | sleep apnea
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I've noticed that several enterprising individuals have taken it upon themselves to sell the Provider Manauls that come with CPAP and Bipap machines. This is different from the User Manuals that ARE given to the patient. The Provider Manuals give information about how to access the Clinical Menu and change pressure settings and other parameters.
These manufacturer states that the Provider's Manual is NOT to be given to patients. This is because some people may attempt to change their settings away from the setting that was determined at a titration study at a sleep lab. The reasons are varied. Perhaps some people want to lower the pressure to make it more comfortable, others may want to raise it. I think that it is fair to inform people that lowering or raising the pressure on your own can have detrimental effects to your health. If you lower it too much, you're not providing enough pressure to fix apneic episodes. If you raise it too high, you run a risk of having pressure-induced central apneas PLUS having an adverse effect on intrathoracic pressure and venous blood return. It's not that the information is a secret protected by an esoteric society, it's that willfully providing this info can easily be made a legal issue as far as liability of the DME for example.
I feel that people have the free will to do whatever they please, but I feel an obligation to educate so that their choices can be informed decisions and what risks CAN be associated. I am a Respiratory Therapist who specializes in Sleep Medicine and PAP applications so hopefully you can feel confident about what I'm saying.
However, the main things that really aggravate me about the Provider Manual sellers is that they play off of peoples' fear and ignorance. They try to convince you that you can save $$$ by making changes yourself with the help of their manual. Let me state once and for all that, DMEs DO NOT CHARGE FOR THIS SERVICE. Changing settings on a CPAP or BIPAP machine is part of being the customer of their machine. Service like this is included. There isn't even a billable code to submit to insurance for this service!?! IF your DME tries to charge you for this service, simply inform them that they are being unethical, immoral, and that if they don't follow the order and adjust the setting, then you will promptly inform your Doctor about their non-compliance. The simple fear of losing a referral source should change their mind quickly.
If you are looking for an answer to your CPAP woes, please let me say that adjusting your pressure setting probably isn't the best way to start about it. I will be soon completing an ebook which I feel will be of tremendous value to CPAP users and people with other forms of sleep apnea. Written from my perspective as an RT, I hope to clear up several myths (like the one above) and point out other little ways that people like to prey on the uniformed.
I hope you have found something of value in my guide. If you have, please vote!
Thank you!
Guide ID: 10000000003664204Guide created: 06/01/07 (updated 07/04/08)
Introduction & Importance
The blood coming from the tissues are transported by the venous system which is composed grossly by the venules, the small and the great veins. The pulmonary artery contains mixed venous blood, which is actually the sum of the superior vena cava and inferior one venous blood. Venous congestion is seen in some diseases and is consequence to abnormal high venous pressure.
Venous Return
The venous return (VR) can be defined as the volume of blood reaching the right heart. If one defines the term central venous pool - roughly the blood contained in the great thoracic veins and in the right atrium - then venous return will be the volume of blood entering this compartment, coming from the periphery. According to the Ohm’s law, there must be a pressure gradient between these two compartments. Keeping others variables constant, the venous return is inversely proportional to the central venous pressure. These two parameters can be plotted in a diagram, yielding the venous return family curves. In hemodinamically stable conditions the VR must be virtually equal to the CO - changes from one heartbeat to another do exist - otherwise blood would be damped back. CVP is always inherently driven to the equilibrium value that makes CO and VR equal. At CVP of 2 mmHg, CO is about 5 l/min.
Major factors influencing venous return
1) Respiratory cycle - Central venous pressure (CVP) decreases with inspiration thereby increasing venous return. This is explained by the negative intrathoracic pressure originated at inspiration, which is transmitted to the great veins of the thorax; moreover, the downward diaphragm movement during this phase helps the pulling of blood toward the heart by increasing the intrabdominal pressure. At expiration, the mechanisms reverse. 2) Venous tone - is governed by autonomous system. 3) Right heart function - The blood reaching the right ventricle is pumped to the pulmonary circulation and therefore will not be damped backward in the venous system. 4) Gravity - discussed below 5) Muscle pump - discussed below
http://www.medstudents.com.br/basic/cardfs/cardfs4.htm
In my opinion, she was only posting that article for us to read.
Den
