RE: Chart Envy
I have studied ASV for years to understand potential risks, and your doctor really threw one out of left field. The kidneys do control bicarbonate levels in the blood, but ASV would generally prevent CO2 saturation, not promote it.
You're sure about him?
RE: Chart Envy
Thanks gents - forgot to mention BiPAP last night was hideous and results were an AHI of 25 - worst nights sleep in some time.
ASV hooked up and ready to go tonight - wish me luck ......
Rob
RE: Chart Envy
Good luck, not surprising your AHI was 25 your back at home at Altitude with no backup rate. I think the altitude is causing the CA rise more than anything which is why your AHI is better when travelling.
Good luck with the ASV I believe it will be the answer to low AHI
RE: Chart Envy
OMG OMG OMG !
First night on ASV was a bit of a revelation - so this is what a good night's sleep feels like ?
This is most natural breathing I've felt since being on CPAP, it really felt great and I feel too much better this morning even with a cold - AHI of 25.2 the night before.......0.5 last night !
I seem to be breathing in slower than is recent past, RESP rate dropped from an average of 13.5 down to 12 and my inhale time last night was far closer to my exhale where this was previously 1:2 ratio - anything to be concerned about ?
I set the EPAP min to 12 to be closer to what I was used to and the max to 24, didn't seem to be close to hitting the max but should I EPAP min, (Sleeprider suggested 8 before), it just seems so much lower than was previously working was why I set it at 12 - suggestions based on charts please and any other thoughts or tips ?
Very happy I made the jump, thanks for the nudge you three !
Rob
03-24-2019, 01:42 PM
(This post was last modified: 03-24-2019, 01:45 PM by jaswilliams.)
RE: Chart Envy
If it was me I would turn off the ramp and reduce the minimum epap to 8 and raise the ps max to 15
There is no need to hose a high minimum epap as the variable pressure support will deal with obstructions as they happen no need to keep the airway splinted in the same way like you need to with an apap as the asv can rapidly increase pressure if it needs to
Great first night
03-24-2019, 06:36 PM
(This post was last modified: 03-24-2019, 06:41 PM by Sleeprider.)
RE: Chart Envy
Damn you're a stubborn cuss! I sure took you long enough to believe us.
I will stick with my suggestion for a lower EPAP min pressure. Although your IPAP clearly moves to deal with events, the selected EPAP at 12.0, never moves. Let's try the lower pressure and see if the higher EPAP is actually something you need. We often need to re-titrate the pressure on ASV. The lower EPAP pressure lets the machine respond in a more dynamic fashion. We may well end up back at EPAP min of 12, but let's take a looks...on the other hand, you were comfortable. That's a big big benefit. Everything looks great here, so feel free to just leave it as-is.
Oh yeah, be sure your doctor knows he needs to refresh his knowledge.
RE: Chart Envy
:-) Funnily enough my wife says that !
Compromise.....
Ramp off
Min EPAP 10.6 - see if it moves
Max PS 10 - see if it tops out (higher than that scares me a bit)
Off to sunnier climes tomorrow, lets see how we go over the next few days at this ?
Is the in:out breathing ratio / rate I mentioned previously ok and nothing to worry about ?
Thanks hugely you guys btw and sorry..........
Rob
03-25-2019, 02:37 AM
(This post was last modified: 03-25-2019, 03:34 AM by ajack.)
RE: Chart Envy
The I:E is ok at 1:1.16 see how it goes. More min PS may help, you have no other breathe shaping adjustments, other than min epap and PS with an ASV.
keep this in mind for later
If I was using my ASV and had your chart. I would keep the min epap at 12 and max at 15 (max adjustment available) I run my min epap close to the 95% because it clears up a some rubbish. If you put up the tidal volume and minute vent charts, scaled to show normal range would be worth it
I'd have min PS 6 you can see on your pressure chart, you are normally above this and I generally get a bit of a flat line here and there on the bottom PS of the chart.
max PS 12 (max adjustment available) because I think you are hitting a ceiling (flat top on top PS of the chart) and the machine can't adjust higher.
RE: Chart Envy
11 glorious hrs of sleep last night with an AHI of 0.15 last night
My exhale time seems to be moving even closer to my inhale time - 2.34-2.66 but the chart that kind of worries me is the flow restrictions one, haven't seen these before and don't know what they mean / should I be concerned ?
Did I understand one of the replies correctly to say that moving pressure support to nearer 6 would fix this / does it need fixed - is it an issue ?
Moving the min EPAP to 10.6 now seems to have that floating from about 11 upwards to about 12.5 - is that low enough for min ? Don't want to go too low as was thinking the difference when it ramps up would be too much of a diff or is it not perceived that way when asleep ? This was my thinking anyway .......
Feeling really great, long day in the sun today and not a bit sleepy, my settings are now as follows :-
EPAP Min - 10.5
EPAP Max - 16
Min PS - 4
Max PS - 14.4
Advice appreciated
Rob
RE: Chart Envy
oops, heres the Tidal Volume and Minute Vent charts requested ?
Rob
