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EPR
#1
EPR
My Airsense 10 has a setting range of 1 2 or 3. what does the range do?  1 vs 3?
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#2
RE: EPR
If your pressure is at say 10. and you put in 1 EPR than when you exhale it drops the pressure to 9. If you had 3 EPR than on exhale it would drop to 7. It's just to make it easier to breath out.

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#3
RE: EPR
Hi GoneFission,
WELCOME! to the forum.!
Good luck with CPAP therapy.
trish6hundred
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#4
RE: EPR
I would suggest that you read this thread:

http://www.apneaboard.com/forums/Thread-...re-Support

For Resmed machines, EPR does not merely change the pressure during expiration.  What it really does is reduce the pressure at all times except for inspiration, and introduces a pressure boost during inspiration.  This can mean that you get less pressure than the machine's display is showing most of the time, and you can get a boost of pressure support during inspiration.

If were titrated with EPR, then you should keep it on a the setting you were titrated.  If you weren't titrated with it, I wouldn't recommend turning it on without talking to your doctor.

If you do turn it on, watch out for more obstructive apneas since the pressure is effectively turned down by the amount of EPR, and watch for the feeling that your lungs are being inflated like balloons when you breathe in.  The feeling becomes worse as you increase the EPR.
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#5
RE: EPR
I'm sorry, but I can't agree with that, that may be your experience, but it isn't everyone's by a long shot. i think walla has it right.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#6
RE: EPR
I believe this study more closely approximates Rezic's hypothesis.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773618/

Abstract

Study Objectives:
Pressure-relief features are aimed at improving the patient's comfort during continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea. The objective of this study was to determine the effect of these therapy features on fixed CPAP and autotitrating CPAP (APAP) treatment efficacy.
Methods:
Seven pressure-relief features applied by three CPAP devices were included in our study (Remstar Auto: C-Flex 3, C-Flex+ 3, A-Flex 3, P-Flex; AirSense 10: EPR 3; Prisma 20A: SoftPAP 2 and 3). In fixed CPAP, the devices were subjected to a 10-min bench-simulated obstructive apnea sequence (initial apnea-hypopnea index, AHI = 60/h) with and without pressure-relief features. In APAP, the sequence was lengthened to 4.2 h (initial AHI = 58.6/h). The residual AHI and mean/median pressure were compared with and without pressure-relief features.
Results:
Compared to conventional CPAP, where pressure was adjusted to be just sufficient to control the simulated obstructive events, C-Flex+ 3, P-Flex, and EPR 3 failed to normalize the breathing flow and did not reduce the AHI. The mean pressures with the three features, respectively, were 1.8, 2.6, and 2.6 cmH2O lower than the conventional CPAP. Compared to conventional APAP, similar levels of control were observed with pressure-relief features, apart from P-Flex where the delivered mean pressure was lower and residual AHI greater. The device-reported mean/median pressures in APAP with A-Flex 3, P-Flex, EPR 3, and SoftPAP 3 were higher than that measured on the bench.
Conclusions:
Pressure-relief features may attenuate CPAP efficacy if not adjusted for at the time of their introduction. In clinical practice, efficacy can be ensured by increasing the therapeutic pressure delivered by fixed CPAP or by enabling the pressure-relief features prior to initial pressure titration. Device-reported pressures in APAP devices with pressure relief activated may overstate delivered pressures.
Citation:
Zhu K, Aouf S, Roisman G, Escourrou P. Pressure-relief features of fixed and autotitrating continuous positive airway pressure may impair their efficacy: evaluation with a respiratory bench model. J Clin Sleep Med 2016;12(3):385–392.[/size][/color]
Sleeprider
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#7
RE: EPR
You try to give a simple answer to a simple question and everyone wants to jump in and prove how smart they are.

Annoyed-and-disappointed
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

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#8
RE: EPR
(11-24-2017, 11:36 AM)Walla Walla Wrote: You try to give a simple answer to a simple question and everyone wants to jump in and prove how smart they are.

Annoyed-and-disappointed

My personal experience is that the simple answer is often the incorrect answer.   Grin
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#9
RE: EPR
I see this issue as a simple understanding of bilevel titration. While my opinion on this is somewhat new to the forum, it is not without considerable support in the studies and practices of treating sleep disordered breathing. EPAP controls OA and flow limitations. Pressure support treats hypopnea (if available). Excessive ventilation can contribute to CA. If we keep it simple, exhale pressure relief, particularly as implemented by Resmed is equivalent to bilevel. It is available in the mask pressure chart for anyone interested.

Using EPR can move a titrated patient's pressure below their effective pressure for obstructive apnea. Learning how to use this feature to best advantage remains a challenge for both professionals and forum members.

I'm not here to prove I'm smarter than anyone else, regardless of the conclusion you must logically make. Smile
Sleeprider
Apnea Board Moderator
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____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: EPR
(11-24-2017, 05:01 PM)Sleeprider Wrote: If we keep it simple, exhale pressure relief, particularly as implemented by Resmed is equivalent to bilevel.  It is available in the mask pressure chart for anyone interested.

Yes, that is my premise.  

Where does one find the mask pressure chart you're referring to?  

My other premise is that Respironics C-Flex is actually expiratory pressure relief, while A-Flex/C-Flex+/Bi-Flex is probably an attempt to mirror Resmed's offering without subjecting them to patent litigation from Resmed...
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