CALLING ON ALL EXPERTS ON AUTO-CPAP... thanks!

What kind of scenarios would prompt a physician to increase a persons auto cpap whos setting is 4-20 cwp? ...and why?

If the Physician was worth anything he wouldn't prescribe settings of 4-20 cmh2o.

rtstudent wrote:What kind of scenarios would prompt a physician to increase a persons auto cpap whos setting is 4-20 cwp? ...and why?

The problem with setting an AUTO's starting CMs well below titration, is that it takes minutes for an Auto to increase pressure by just a couple of CMs. Some will even stop altogether after raising 3 CMs & will wait for minutes before resuming monitoring. If a cluster of 'events' that lead to a non-flow apnea, occur quickly, the machine may always be late to the party if it has several CMs to raise pressure by.

Setting an AUTO to NO LESS than 2 CMs under titration gives the user some pressure relief, but allows the machine to get to the target needed pressure much quicker than if it was initially set at the lowest setting (4 CMs).

There has been confusion about AUTOs since they were introduced. One confusion stems from the simple belief that an AUTO always raises pressure to clear any apnea. But the design of an AUTO is to monitor for pre-cursor events and adjust pressure in anticipation of an apnea cluster on the basis that it can prevent the apnea cluster occurring if it steadily adjusts to reduce the precursor events (flow-lims, hypopneas & snores). If AUTOs could clear any apnea then the AI score would always be 0.0 which they rarely deliver.

An AUTO set to 2 below titration can deliver optimal therapy.

DSM