Should you increase pressure support if you don't have centrals?

[drmaestro]

Hi,

Do you think it is beneficial to increase pressure support if you don't have centrals? Would it be better for O2 saturation? The problem here would be that due to the wide gap between EPAP and IPAP, the device can have diffculties in answering to obstructive events, as even slight increases in EPAP would mean increases in IPAP, and high IPAP can wake you up if you were sensitive to pressure. It would be better to have a mode where PS would change dinamically, for example you start with a PS of 4, but if there is a need to increase the EPAP, the PS would decrease to keep the IPAP fixed or increased less than EPAP. Is there such a device?

Thanks...

[Gideon]

That is the purpose of limiting the max IPAP 
EPAP manages apnea,  
IPAP, often vis PS, manages flow limits, hypopneas, RERAs, UARS.

Centrals are often caused by improved ventilation caused by Pressure Support which also improves oxygen levels, but also increases the flushing of CO2 out of the system. 

That is also some of the theoryPSehind the variable  PS that Philips uses,. But like pressure on PS machines we often need to increase the min PS to get the job done.