Remstar Auto With C-Flex

Yes, Paul, I would agree with that statement. The entire technical premise on which C-Flex does not even require a dedicated re-titration is based on the fact that obstructive events tend not to manifest at the beginning or middle of expiration. That is where pressure reduction can be afforded with relatively little obstructive risk so to speak.

There will be rare patients who do manifest obstructions during the beggining and middle of expiration, and they would need a dedicated C-Flex titration as BetterBreathingBob has noted here in the past. There will also be rare patients for whom IPAP/EPAP pressure differentials (seemingly the transitions) just seem to confuse their respiratory drives with respect to breath rate and/or machine synchronization. There is not a single xPAP platform on this planet that doesn't have it's slim percentage of patients for whom the machine is not well suited.

Thanks again. I sure wish there was a mechanism for us to try out these different systems before we had to commit to one or the other. Sounds like a business opportunity hidden in that request.

I agree, Paul. It sure would be ideal if patients were fitted for an xPAP machine as well as if they were being fitted for shoes. After all, being issued straight CPAP is like being issued standard issue military boots!

On the subject of a dedicated C-Flex re-titration being unnecessary: that statement is relative to the original CPAP-flavor of C-Flex. Of course, the Remstar Auto with C-Flex will automatically titrate inspiration and expiration throughout the night to eliminate obstructive events. I view this as yet another margin of safety negating any worries relative to "exacerbation" of hypopneas/apneas. I really do think C-Flex sounds like a very good thing.

The important opinions, however, will undoubtedly come from those who actually use C-Flex. Hands-on assessments are guaranteed to be more revealing than some tech-head's interpretation of patent descriptions...

The lab that I worked in had the ability to titrate using cflex and biflex, along with straight cpap and bi-level.

I think having these as tools is a good idea. Though they are exclusivly linked to Respionics, they can make the difference in patient comfort and compliance.

As you might have guessed the doctor wrote almost all of her prescriptions with cflex included.

Ted

Hi Ted. Makes complete sense to have those tools available since some patients will require a dedicated C-Flex or BiFlex titration. I would expect BiFlex titrations to be mandatory much more often than C-Flex titrations, since more pulmonary patients (such as COPD) are BiFlex-bound rather than C-Flex-bound. Curious if you perchance got the impression that either Respironics or even the sleep industry is migrating away from the following initial stance that Respironics asserted regarding C-Flex/BiFlex titrations:

1) C-Flex or BiFlex bound before the initial titration, then administer a C-Flex/BiFlex titration

2) Unplanned migration from CPAP to to C-Flex, then no dedicated re-titration is necessary for the basic OSA patient

3) Concomitent pulmonary disorder(s) discovered after the initial CPAP titration, then retitrate on C-Flex/BiFlex---more often than not on BiFlex for concomitant pulmonary disorders

C-Flex tends to be used most often to achieve necessary comfort. BiFlex may achieve additional comfort, but it might also be deployed on certain pulminary patients to achieve a much more precise PEEP setting.

Ted! It's always good to chat with you!

That was me, Ted. Once again inadvertently logged off in the middle of typing a post! I think your phpBB implementation may have issues with login retention relative to "sid" (session ID).

Anyway, it's nice to be here as your "guest"! Heheh!

-SWS

john57 wrote:During the interview the RemStar folks did say that that the C-flex setting of 3 does not equal a 3cm of reduction but that is all they will say. On the other hand I think that many people can tell the difference even long term users of straight CPAP when C-flex is engaged

Interesting....why don't they fess up and give more details? Sounds sinister!