(04-14-2016 05:43 PM)palerider Wrote: you must have missed the link sourcing the comment from NIH.GOV.
and, no, a cpap does not blow *anything* into the lungs. you have to use normal respiration to do that.
simply put, a ventilator is a device that *breaths for you* when you are unable to do so.
a cpap, or plain bilevel, DO NOT DO THAT.
cpaps and bilevels DO NOT TREAT central apnea, NIV machines do.
I think this could be a really useful discussion but perhaps only if you, Palerider, could please try to moderate your wording sometimes so that you may then come across as less 'definately correct' about everything and less 'angry' (all those capital letters, which I understand mean 'shouting' on web forums). For me Apnea Board has always been a beacon of calm and friendly excellence - the Moderators here clearly do a great job (thank you) at preventing trolling. Lets keep it that way.
Back to the substance of the discussion - my opinion, for what it's worth, is that this debate is mostly semantics, and history. The history: I would hazard a guess that my ASV machine is as sophisticated as the 'ventilators' used for critically ill patients in hospital not even 20 years ago. And the machines I remember were about the size of a small wardrobe! But now us (often fit and healthy) people can have the same functionality on our bedside table.
Now the semantics. If one looks at some random (assorted dictionary) definitions of 'ventilation' we find:
'The supply of air to the lungs, especially by artificial means'
'In respiratory physiology, the process of exchange of air between the lungs and the ambient air'
'A machine that mechanically assists a patient in the exchange of oxygen and carbon dioxide'
'A ventilator is a machine that supports breathing. Ventilators get oxygen into the lungs and help people breathe easier'.
So, if one bases the concept on definitions, I would say that all forms of PAP are actually 'ventilators' - i.e. they support 'ventilation'.
The semantic problem then seems to be - what do doctors and lay people think of as a 'ventilator'. I have tried this out on some friends this morning and all the mental pictures described were grim i.e. the serious news in Intensive Care "I'm afraid he needs to be put on a ventilator". When I then said " so what do you think about my little machine?" (none of them know the difference between CPAP and ASV) - "Is that a ventilator?" all the answers were along the lines of "No of course it isn't. Well, actually ….... perhaps it is? You say it opens your airway blockage? and it improves your blood oxygen levels? OK then, it improves 'ventilation', so it's a 'ventilator' "
Perhaps it could be useful instead to think of 'ventilators' as:
1. First of all, 'invasive' or 'non-invasive'. Invasive is via a tube in the airway (placed through the mouth or through an external incision in the neck - a tracheotomy), non-invasive is via a mask
2. Any machine that improves 'ventilation'. I would put all versions in this category - from the most basic CPAP machine to the highly sophisticated modern equivalent of an Iron Lung.
3. And within category 2, those machines that will *also* actually 'breathe' for people who have lost the ability to breathe on their own. Which is either:
- for people with certain sleep apnoea syndromes (usually with a noticeable frequency of central apnoeas) who only need occasional support, a reminder if you like, to breathe. Bilevel PAPs with ST, and ASV machines, can do this.
- for people with a variety of different serious medical conditions e.g. paralysis of the respiratory muscles, who need this support most of the time, even for every breath, on a temporary (usually in hospital) or life-long (often used at home) basis.
Comments (but only non-shouty ones please!) are very welcome.
My current pressures: Auto-ASV. EPAP 12-14. PS 3-10