Newbie on AVAPS

What short bursts?

SAG

Hey guys,

You are turning up some terrific material here - stuff I have been searching for over a long period & not been able
to find, certainly not this quality of info - I started by using the patent numbers from the back of the machine but
just ended up with lots of 'parts' of the story.

Keep it coming - I am sure we will get to a point of agreement soon - maybe it won't be called FOT or FOM
but lets keep digging it up & working through it - good work !

DSM

StillAnotherGuest wrote:What short bursts?

SAG

Those short start-up pressure bursts that occur only because Doug's machine has a sticky bearing. I don't see any reason why we can't universalize those less-than-one-second puffs across the entire production run... and then happily pretend it's by lofty design.

hey dsm:

Next time you do your hold your breath test, try it with BPM=Off, I wonder if that puff goes away.

Snoredog wrote:hey dsm:

Next time you do your hold your breath test, try it with BPM=Off, I wonder if that puff goes away.

Snoredog,

That very thought crossed my mind. I just also read through the patent SWS quoted from & that doesn't look like it is out of a Bipap Auto SV - it looks more like an algorithm from an Auto Cpap or an Auto Bilevel.

If I can devise a repeatable test that otherrs can get the same result from then I think we will have an acceptable proof - am wondering if it is possible to capture it on the dial manometer. If yes I can video it.

Just want to repeat that in the Vpap Adapt SV, I have experienced a sequence of puffs like a pulsing effect. Banned must have also felt it at some time or another ? - Banned can you comment pls ?

In the Bipap Auto SV it is always 1 short single puff sometimes followed by another depending on if I breathe (even a little) or just hold my breath.

I need to make this repeatable.

DSM

Snoredog wrote:

-SWS wrote:And what else are short puffs or probes used for if not event differentiation exactly as Respironics describes?

Alright, I would like to hear at least three more pages of argumentative denial from Snoredog regarding just how those short puffs are an absolute impossibility because he knows perfectly well how the autoSV machine REALLY operates.

<more argumentative tail chasing will shortly ensue that I won't be participating in>

You can't leave. If you leave people are going to come by here and ask:

Where's -SWS?

and you KNOW what I will say, he left cause he got tired of being wrong all the time,

I give you the chance to substantiate your position and show where you are not wrong and you can't do it.

your data is invalid.

Me thinks THIS Patent US 200702212224AI Entitled Ventilatory Control System does a hellva lot better job in describing the patented technology used on the Adapt SV:
http://www.google.com/patents?id=zd6hAA ... on#PPA1,M1

Look at paragraph {0062} and {0063} and Fig. 6, believe your "puff" is seen as item 17 after item 22 has elapsed.

Sorry, but it is a "timed" event not a FOM method.

Snoredog,

This patent is a great find, but, it appears (a first glance) to be for a ventilator that can monitor CO2 and react to the detected level as well as tv and av peak flow. So, if this is so, then it may not relate accurately enough to the Bipap Auto SV. BUt I sure as hell am impressed

DSM

#2

Whether it relates to a CO2 sensor being part of the device or not - this patent description is downright exciting in what they claim they can do. The best description I have seen yet - I haven't yet come across a 'puff' sensor description but am hoping I do or that tests prove they did add such a feature.

D

dsm wrote: This patent is a great find, but, it appears (a first glance) to be for a ventilator that can monitor CO2 and react to the detected level as well as tv and av peak flow. So, if this is so, then it may not relate accurately enough to the Bipap Auto SV. BUt I sure as hell am impressed

Whether it relates to a CO2 sensor being part of the device or not - this patent description is downright exciting in what they claim they can do. The best description I have seen yet - I haven't yet come across a 'puff' sensor description but am hoping I do or that tests prove they did add such a feature.

D

I mentioned that years ago when the Resmed Adapt SV came out (SAG thought I was nuts), the Honeywell 9000 series MAS was certainly capable of monitoring that aspect, but the problem is you have to monitor it somehow right at the mask and overcome the incoming air.

I knew I should have patented it dang it Don't forget to look at FIG 6., item 17, think that may be the puff.

Snoredog,

That patent raises so many interesting issues. It looks too new to be included in the Bipap Auto SV unless newer versions of the bios include aspects of it.

http://www.google.com/patents?id=zd6hAA ... on#PPA1,M1

Anyone who wants to get to the heart of what modern xPAP respiration is all about and can wade through some acronyms, should read the section called BACKGROUND Of THE INVENTION on page 1 following the diagrams. I promise that the language is not that complex that most can't figure out a lot of what they are referring to but you do need to know these issues

1) the significance of too much or too little CO2 in the blood

Some references ...
1. http://en.wikipedia.org/wiki/Hypocapnia
2. http://en.wikipedia.org/wiki/Hypercapnia

2) In particular read para 0008 & 0010 (quite readabble)

3) 0013 introduces the importance of CO2 and O2 control (in this patent case, via supplementary supply)

4) 0015 talks about the concept of VarPAP - very interesting even if it really focuses on CSR (Cheynes-Stokes Respiration)

5) Paras 17 on are a good summary. Promotes the idea of Servo Ventilation & I am certainly a great believer

DSM







2. http://www.healthatoz.com/healthatoz/At ... idosis.jsp
2.

dsm wrote: 5) Paras 17 on are a good summary. Promotes the idea of Servo Ventilation & I am certainly a great believer

DSM

No No, not paragraph 17, "item" 17 shown in the graphical drawing Fig. 6, the sine wave drawing, think it is page 6 of 21, the graphical representation of flow, it shows what appears to be your "puff".

Snoredog wrote:

dsm wrote: 5) Paras 17 on are a good summary. Promotes the idea of Servo Ventilation & I am certainly a great believer

DSM

No No, not paragraph 17, "item" 17 shown in the graphical drawing Fig. 6, the sine wave drawing, think it is page 6 of 21, the graphical representation of flow, it shows what appears to be your "puff".

Snoredog,

I looked at it but without the matching description could not see that 'puff' even though there is shown a signal line that looks like a 'puff' - fig 6 is described in the text as a graphical rep of low respiratory drive ?

DSM

#2 Am reading para 62 which describes diag 6 - will add more later

#3 This is not Bipap Auto SV but is fascinating info - para 0064 talks of controlling rebreathing by an active leak valve & evan talks of a dynamic deadspace controller or a reservoir of co2 for rebreathing or even supplementary co2. Fancy thinking !!!.

#4 Snoredog, this patent seems to be referring to a dream machine that controls both O2 and CO2 - not a current model machine (which the Bipap Auto SV is). It is like reading a vision of the future. Very impressive & reflects the effort the various researchers appear to be putting into improving the CPAP experience. A very absorbing read.

#5 One fascinating proposal is the notion of dynamically reducing epap in order to boost CO2 retention - interesting idea !

D

Did some further tests looking for puff (the magic dragon) and they are now just as elusive.

Not a one ? - I tried a test at start of sleep but all I could get was what seemed like a 1 sec burst of pressure that starts at a low pressure & raise quite a bit higher very quickly (may be 200 millisecs in) - the 2nd pressure seems much higher than the intial pressure, kind of like a jab-smack effect.

On waking I tried the same process as the morning before but still couldn't trigger the 'puff'.
So, at this stage the test is not repeatable.

DSM

PS, I hadn't turned off BPM but will also try that tonight for the whole night, just to see what it does to those AP scores.

Let's say they were able to measure CO2 levels at the mask and said mask included a regulator "valve" to control the amount of CO2 allowed to build up, small electronic circuit on the mask that ran back down the hose to the machine that sent the signal back to the processor on the machine, it then looked at respiration and controlled it to resolve central dysregulation.

But I guess you can do that now with control of breathing like the Adapt SV does.

Snoredog wrote:Let's say they were able to measure CO2 levels at the mask and said mask included a regulator "valve" to control the amount of CO2 allowed to build up, small electronic circuit on the mask that ran back down the hose to the machine that sent the signal back to the processor on the machine, it then looked at respiration and controlled it to resolve central dysregulation.

But I guess you can do that now with control of breathing like the Adapt SV does.

Yup

DSM

(you were meaning the Vpap Adapt SV weren't you )

dsm wrote:I just also read through the patent SWS quoted from & that doesn't look like it is out of a Bipap Auto SV - it looks more like an algorithm from an Auto Cpap or an Auto Bilevel.

Unfortunately none of the older autoSV documentation included patent listings---at least none that I could find. However, the 2007 BiPAP autoSV user guide does include patent listings. I only spotted those numbers less than an hour before I originally cited patent number 6,539,940 a page or two back in this thread. Anyway, Respironics lists them all on page two of this document: http://global.respironics.com/UserGuide ... 040200.pdf

The various autoSV features are undoubtedly spread out among several of those patent protected documents. And any given patent number disclosed in the above document conceivably lends one or few design features employed by the BiPAP autoSV. I don't plan on searching for the hard-to-replicate puffs. However, if we ever get to the point where we want to dig into the autoSV patent numbers for current or future discussions, the above 2007 User Guide patent listings should be the numbers to delve into.

With that said, it's possible that certain key features might not even be in the above patent descriptions. Two situations that seem to often cover that situation are: 1) implementations that can no longer be patent protected, and 2) purchased/leased rights to use ideas patented by a third party. The Resmed VPAP adaptSV comes to mind as an example of that second point. That SV machine supposedly uses the Younnes implementation of PAV (adjusting both Pressure and Frequency)---and those Younnes details are specifically excluded from Resmed's patent descriptions of the VPAP adapt SV.

SWS,

I just a few minutes ago went looking for the original patent and believe I have it (what they called the HeartPAP & later the Bipap AutoSV). Applied for in 2001 & granted in 2004 - I also have what looks like a followup applied for in 2004 & granted in 2007.

I have hard copies & 1st read them & if they are the genuine article will post links to them.

As mentioned I was not able to repeat those 'puffs' but I am satisfied they are there - just wish I could trigger them predictably. What did happen was close to what you had found.

I am wondering if the puffs were added in once Respironics expanded the HeartPAP to deal with csdb rather than just csr. Thus the HeartPAP becomes the Bipap AutoSV.

DSM