[Treatment] Supplimental O2

[justMongo]

Lately there have been several threads on how Bilevel with too much pressure relief, can cause apnea events do to reducing CO2 in the blood -- ergo: reducing central ventilator drive.

http://www.apneaboard.com/forums/Thread-...entilation

I'm prescribed 2 LPM of O2 into my Bilevel stream (from a concentrator.) I noticed some folks are at 3 LPM.

I was told by my doc not to dial up the O2 too high; but he didn't elaborate. I surmised that too much flow not regulated by the xPAP machine might interfere with the trigger from IPAP to EPAP. (Engineers think like that!)

Now, I'm wondering if it might have a detrimental effect on respiratory drive. Any thoughts?

[Peter_C]

I'd really like to help, but this one is beyond my knowledge.

Everything I've learned about using O2 came from my father in-law passing from COPD and the last four years of his life.

I know there are 'hard' limits for the maximum use of O2 - and many of the reasons why you don't want to randomly raise your use is because the body will quickly adapt to it, and expect it, and it's tough to lower it (safely) once raised.

Everytime my father in-law went into hospital, they would not release him to come home until he could maintain at 3 LPM or less. Even though he was dying, us raising him up to four (or more) was not ever an approved option by the Docs.

Your need may have nothing to do at all with what little I've learned. 3 LPM seems to be a magic number a 'cusp' if you will. But am not entirely clear as to why.

[justMongo]

I'd really like to help, but this one is beyond my knowledge.

Everything I've learned about using O2 came from my father in-law passing from COPD and the last four years of his life.

I know there are 'hard' limits for the maximum use of O2 - and many of the reasons why you don't want to randomly raise your use is because the body will quickly adapt to it, and expect it, and it's tough to lower it (safely) once raised.

Everytime my father in-law went into hospital, they would not release him to come home until he could maintain at 3 LPM or less. Even though he was dying, us raising him up to four (or more) was not ever an approved option by the Docs.

Your need may have nothing to do at all with what little I've learned. 3 LPM seems to be a magic number a 'cusp' if you will. But am not entirely clear as to why.

Peter_C:

Sorry to hear about your father-in-law.
I wish doctors would be more forthcoming with information.

It also occurs to me that one adjustment the body might make to a higher O2 concentration would be to produce less red blood cells. I'm borderline anemic. I miss low normal by a tiny fraction. Could be from supplemental O2.

I was hospitalized in 2010; and had my xPAP Rx with me. The machines used in the hospital can be set to deliver "air" with a preset O2 percentage; and they translated mine to 30% O2. (Normal air at sea level is about 20% O2)
I asked the RT how that was calculated from the 2 LPM Rx; and the RT (Respiratory Technician) didn't know.

I think it's just a SAWG (Scientific Wild *** Guess)

[Peter_C]

FYI? They put me on 'iron' pills, one pill a day (over the counter), and it's bringing my numbers back up slowly... last test was 11.9 - still low, but getting better.

[retired_guy]

I was diagnosed with severe emphysema about 8 years ago. I know what it's like because I had a first wife die from it much in the same manner as Peter's Father in law. I don't do oxygen, nor do I do wheelchairs and such. Xrays last week look the same as those taken 8 years ago, so I'm doing ok. My wife deteriorated to requiring the o2 and then wheelchair and then not even being able to use the wheelchair before she passed.

I'm convinced, that if at all possible, do not go down the road towards supplimental oxygen until/unless you absolutely must. That's a personal decision that has to be made in concert with solid medical advice. But too often we get treatments to "make us feel better" when in reality our body needs the discomfort for a little while to effect a treatment plan of its own.

Yes, it's all about oxygen levels in the bloodstream, and I can't speak to what is too high or too low for any given person. I know that with my "severe" emphysema, I try to keep mine at least at 92 through breathing technique and the like. Rather than just pump o2 in in the night, I thing it would be marvelous if their was a device that would alert you if the 02 fell below a certain point, and allow you to wake up and breath a little while.

I know eventually the odds are pretty good that I run across some well meaning person that "did not get the flu shot because they never get sick," and get the flu and check out of here. Or maybe I'll get shot climbing out of someones bedroom window when her husband comes home. But I am not going to allow my emphysema to kill me without a lot of help.

[PaulaO2]

Retired_Guy: a pulse oximeter with an alarm would be able to alert you to dips in the O2.

I have the CMS 50D Plus, very basic model. I can set an threshold of "if it gets below this", sound an alarm. So I'm sure the better, more comfortable models such as the wrist ones would have the same.

And I can see your point with the supplemental O2 in your case. I think it is akin to why wearing a knee brace is sometimes not a good idea. If you wear one too often or too long, the muscles get too used to not doing their job and get weaker. I can see how maybe the body gets the same way with the supplemental oxygen.

[Peter_C]

I have the CMS50F - which is a wrist mounted, rechargeable device with a most wonderful secure finger probe. Date of course (up to 30 hours worth), software (basic) comes with it, and you can set separate alarms for too low, too high, and same for heart rate (low high). Because of all the PEs I have had, my *norm* is 93-95, at night 89-91 - the doc states when awake, I must be able to get back to at least 92 within 30 seconds of stopping whatever I am doing. He wants me to maintain 90 or above at night, he does not care about sudden drops, as long as I can bring it back within reason.

With my father in-law, if he could not maintain 90 when on 3LPM, it was hospital time. Brain cells start dying if your O2 drops too much or for too long - sadly, we saw this happen to this mentally smart and quick (retired engineer) 72yr old man.