EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA

[mdmarmd]

I was thinking of trying/getting back to the P10, but now I'm thinking maybe I should stick with the Brevida...


Interestingly,  we might have had this decision made for us, and this whole discussion would have become a moot point:

Fisker & Paykel sues Resmed over Airfit p10
http://www.itcblog.com/7936-fisher-payke...sk-systems

Resmed Counter sues
https://www.massdevice.com/resmed-files-...er-paykel/

They settle
https://www.massdevice.com/resmed-fisher...ent-suits/

[Crimson Nape]

That is interesting. I, like many others, would like to know how it was settled. Also, it appears the the countersuit story appeared 6 days before the original lawsuit story.

[Dog Slobber]

That is interesting.  I, like many others, would like to know how it was settled.   Also, it appears the the countersuit story appeared 6 days before the original lawsuit story.

ResMed and F&P have been duking it out in various courts since 2016.

In October 2018, Resmed was victorious over F&P for patent infringement in Germany. This victory set the tone for settlement.

http://investors.resmed.com/investor-rel...fault.aspx

[Sleeprider]

We are getting off-topic to the original thread, but I have used nasal pillow masks by Resmed since 2007 as outlined in a previous post. The P10 is nothing more than an evolution of the Swift II, Swift LT and Swift FX and finally the Airfit which brought the quiet diffuser vent. I really don't see Fischer Paykel prevailing.

[mdmarmd]

A brief update regarding the clinical effects of these levels of hypercapnia.

I conversed with an expert in environmental exposure to elevevated CO2.  The person is primarily experienced with elevated CO2 in work environments and accidental exposures to high levels.  As such I could not get answers to some of my more clinical questions.

This confirmed that there is a paucity of data regarding the consequences  at levels of 40,000ppm (serious risks) to 100,000ppm (immediate death).  This has do to with ethical restrictions on doing human studies that have such high risk to health and life.  For example, there was a study with exposure at 30% CO2, but only with a few breaths.

This resource also said the aspect of most interest is the O2 level since at 45,000 ppm CO2, the displacement of O2 may be quite consequential.  One could imagine if a user had COPD with both chronically low O2 and high CO2, this interplay between the two gases might be of critical concern. Still, the CO2 probably has direct toxicity at these levels as well.

I also mentioned the therory that hypercapnia would automatically trigger central nervous system alarms, which would compel the person to pull off the mask or mouth breath.  The answer was that there is no guarantee that this would come to your defense since there are complex factors, including concommitent medical or pharmacological influences that may override this arousal mechanism.

The fact that prior to treatment, many of us may have slept right through apneic events where we suffered both high CO2 and low O2 reinforces this view. I recall a patient who said when he had his sleep study his events were up to 2 minutes long! Wonder what his CO2 was then.

[ghce]

Must be pretty common for apnea events to be quite long? when I was staying overnight at my local hospital for an unrelated stay to sleep studies a nurse timed my not breathing episodes at a duration of more than a minute each episode. My sleep study done at a later date had an AHI of 48!
When I first started CPAP my pressure was set too low at 11.00cm h2o, my obstructive episodes were still in excess of 75 seconds for the most part, I changed it to 13 and it all went away.

So yes this whole Co2 issue is of great concern.

[pabmd]

What do I have to do to be allowed to post here?

[pabmd]

My empiric observations with the P10 are totally consistent with those reported by mdmarmd. I have been using the mask for 3+ years. I am convinced it clogs up easily and frequently from condensation. The possibility that I am trading hypopnea/apnea for hypercarbia is frightening. After reading this thread, I have ordered a Brevida, and I bought a WaterPic. I think punching a few holes in the P10 might also be a good idea. The leak rate is very minimal.  Thank you, mdmarmd, for this valuable information.

[NotADr]

mdmarmd, what pressure setting did you use for your WaterPik when you saw good results? My WaterPik has a dial that goes from 1 to 10, but I've been reluctant to turn it up too high for fear of damaging the filter. I've been using a setting of 5. However, I'd prefer to crank it up as high as possible, and up to 10 if it doesn't cause damage.

[mdmarmd]

I am using a WaterPik Aquarius and set it at #10.  I don't think it's likely to damage the fibers.  Probably less risk than frequent brushing.  
I do think there is some possible crazing which can occur to the plastic fibers over time. 

Now that I know what I am looking for, I will use just one of my 7-8 frames and just wash it periodically and then view it magnified so I can see if there is any evidence of increased damage to the fibers over time. That will give be some idea how long I can use a frame before I need to replace it.