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+--- Thread: Importance of flow limits when titrating ASV (/Thread-Importance-of-flow-limits-when-titrating-ASV)
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RE: Importance of flow limits when titrating ASV - raylock1 - 04-15-2023
(04-15-2023, 09:20 AM)Rich66 Wrote: The important question is "how do you feel". Also, in my opinion, try to keep leaking to a very minimum so you get true scores from the graphs to help you.
Thanks Rich66, That is a very helpful post. I have been experimenting but not really understanding the whys of the various pressure setting. Over quite a range of Ps and EPAP settings, my AI's are usually zero and only an occasional leak. I was concerned with the number of flow limits. I have not focused on how I felt or how well I slept. I like to tinker which sometimes gets me in trouble
RE: Importance of flow limits when titrating ASV - raylock1 - 04-18-2023
(04-15-2023, 09:20 AM)Rich66 Wrote: The important question is "how do you feel". Also, in my opinion, try to keep leaking to a very minimum so you get true scores from the graphs to help you.
I do feel lousy first thing in the morning, slight headache, lethargic, poor vision. Those go away after a few minutes of activity. I currently have my ASV set at EPAP min 7 and max 15 with Ps min at 3 and max at 15. AHI's at this setting are zero. The original prescription (two years ago) was EPSP 9 and Ps at 0. It appears that I should reduce my EPAP min to a point where I begin to see AHI's (or just above) and then deal with the Ps. At least I now have a strategy. Thanks again.
RE: Importance of flow limits when titrating ASV - Rich66 - 04-18-2023
I found it takes a lot of tinkering and patience to find out what works and what doesn't. Also, making more than one change at a time makes it difficult to know which change worked and which didn't. Having a strategy is good, and you should follow what you think is best. If I was getting headaches, I'd drop that PS Max to about 10 and see how it goes. Drastic changes aren't real good, but neither are headaches.
RE: Importance of flow limits when titrating ASV - raylock1 - 04-22-2023
I reduced the PS max by 10 and that seems to have eliminated the slight headache and lethargy first thing in the morning. Thanks for that Rich66. Now I am trying to understand why that makes a difference. I am guessing that the reduced pressure may reduce the Co2 washout (causing less hypocapnia ?). But the symptoms of HYPERcapnia are what I had, i.e. headache and lethargy. They are not the symptoms of hypocapnia. Maybe I just have this wrong.
Is there any way from OSCAR to know how many CA's were treated by the ASV? If there were, maybe the number of flow limits which are due to chest immobility could be measured.