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+--- Thread: ASV Machine (/Thread-ASV-Machine--20842)
RE: ASV Machine - ajack - 02-02-2018
I wouldn't be restricting the algorithm at this stage. I would follow the titration guide defaults and boundaries of raising the min epap till the UA and H are resolved. as per page 41. min epap 5 isn't doing this. Time will tell, 6 might or being closer to the 95% could
https://www.scribd.com/document/353402827/cpap-bilevel-Titration
I'm at a loss why max epap 8, when the 95% is 8.46 and the max epap used for the night was 9.4? I can't see this clearing up the obstructive UA/H.
I would have the max epap 10 or above and have no reason to reduce from the default 15, to keep it out of the way.
I don't have an opinion on the min PS yet, I think it would depend on the MV and TV charts. I note there is a RR of median 18.8 If the stat chart can give an indication, the median PS may have been 4. looking along the min PS line, it was consistently above PS:3
I don't see a need to reduce the PS when it was being used to clear H events and other unflagged areas, as indicated by the max ipap 24.3
RE: ASV Machine - Sleeprider - 02-02-2018
(02-02-2018, 08:59 PM)ajack Wrote: I wouldn't be restricting the algorithm at this stage. I would follow the titration guide defaults and boundaries of raising the min epap till the UA and H are resolved. as per page 41. min epap 5 isn't doing this. Time will tell, 6 might or being closer to the 95% could
https://www.scribd.com/document/353402827/cpap-bilevel-Titration
I'm at a loss why max epap 8, when the 95% is 8.46 and the max epap used for the night was 9.4? I can't see this clearing up the obstructive UA/H.
I would have the max epap 10 or above and have no reason to reduce from the default 15, to keep it out of the way.
I don't have an opinion on the min PS yet, I think it would depend on the MV and TV charts. I note there is a RR of median 18.8 If the stat chart can give an indication, the median PS may have been 4. looking along the min PS line, it was consistently above PS:3
I don't see a need to reduce the PS when it was being used to clear H events and other unflagged areas, as indicated by the max ipap 24.3
Similarly, I don't know why you suggested EPAP min 7. Geeze!
RE: ASV Machine - ajack - 02-03-2018
normally for a/cpap a/bpap. As per my signature, I would suggest just under the median 6.9 and infact that would have been 6 and as I said, I'm ok with min 6.
I think that median number will come up as the ASV is titrated. I think it will land higher than the current 6.9 and the min epap 7 will be a bit under the new median, but as I said I'm easy and it will sort itself out.
If that was my chart, I'd run min epap 8. I actually run my min epap about 0.5 to 1 under my 95% epap. It keeps the epap line fairly level.
https://i.imgur.com/fQKFBrf.png
another on a rougher night during my titration
https://i.imgur.com/kseqgQc.png
RE: ASV Machine - Hojo - 02-03-2018
I personally never tolerated high CPAP pressures and now that I'm on ASV, I still don't like the high EPAP pressure and while I was told to start at an EPAP of 5, I didn't tolerate it very well and started at 4.
If it were me, I would make very little upward changes in EPAP and not on a nightly basis, usually over at least a 2 night period and 3 nights is even better, until OA and UA events are resolved. I also wouldn't stress out too much on trying to get the AHI down to zero, I'm actually thinking the other way; I want my body to have a respiratory drive and not get too much of a reliance on an artificial machine, but that's just me.
RE: ASV Machine - LarryRapp - 02-03-2018
Here is last night. The changes Sleeprider mentions will be made for tonight. I moved Snore down. If you want me to do anything else, please tell me. I understand the "blowing" now but I haven't had to do anything. Every now and then when I'm awake I feel a puff of air in the mask, but it goes away on its own.
![[Image: UTkTLm1.png]](https://i.imgur.com/UTkTLm1.png)
RE: ASV Machine - Sleeprider - 02-03-2018
So when your doctor asks, "how are you feeling", what's the answer? Feeling better?
RE: ASV Machine - LarryRapp - 02-03-2018
Ajack,
I don't know what the minute vent is (or are). I think I know what tidal volume is but I'm not sure. Thanks!
RE: ASV Machine - LarryRapp - 02-03-2018
Ajack,
Here is a picture of Tidal Volume and Minute Vent:
![[Image: qOeefCy.png]](https://i.imgur.com/qOeefCy.png)
RE: ASV Machine - LarryRapp - 02-03-2018
Sleeprider,
If my doctor asks if I am feeling better (which he has already done) my answer is "Yes, I am much better."
RE: ASV Machine - SarcasticDave94 - 02-03-2018
(02-03-2018, 10:43 AM)LarryRapp Wrote: Sleeprider,
If my doctor asks if I am feeling better (which he has already done) my answer is "Yes, I am much better."
Great Larry. That's our collective goal, getting you to feel better. Good numbers like your post to ajack are nice to see, but that you feel better is nicer still. Congrats.