Ah, family obligations have forced me BACK to my desk and thus the computer again. No rest for the weary today.-SWS wrote:I think that's a caveat for short-sighted servo ventilation machines without "volume assurance" (hence the AVAPS acronym for that latter machine). The designed purpose of the "volume assurance" value/number programmed by clinicians is to prevent that diminishing-target scenario you just described. Volume targeting will never be lower than that assurance number programmed by the clinician.Muffy wrote:Further, if it is the latter (which apparently it is), then the suggestion of using ASV as proposed by another poster who shall remain nameless Banned would be totally inappropriate as the less than 100% target keeps getting smaller and smaller as the hypoventilation persists.
That said, I agree that volume ventilation (not AVAPS) is the best modality for more severe respiratory failure (as opposed to less severe hypoventilation that is commonly associated with neuromuscular disease, severe obesity, etc.). Any way you slice it AVAPS immediately and primarily targets pressure, hoping to hit that minimally-assured secondary volume target. And AVAPS can take quite a few breaths to get the patient back on volume target as well.
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Madalot, I'm sure you recall our proposing that we use your learning curve toward knowing how to help others in a similar situation. You seemed amenable to that idea at the time---or at least didn't object.
Well, this is the discussion we need toward knowing how to help others in a similar situation... You just might continue finding information of use in these unfolding discussions as well. At least that is my hope.
If my situation helps just one person get better treatment or care for themselves, it will be worth it. Absolutely, positively. And these banterings back and forth are just fine -- until the bantering turns to telling me that I must do this or must do that, or even more importantly, saying things that make me question my medical team's ability and their handling of my case. Questioning is okay, but not some of the things that have been said. For example, you don't need this, you should have this and there's no way that's possible, or you don't qualify for that expensive "toy" -- these types of comments aren't helpful to anybody and detract from the purpose that so many seem to have for my threads/situation.
Weary, weary, weary --
