Inspiratory Flow Limitation

[wolson]

Here is a very interesting paper on flow limitation that many of us (including me) have:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688581/


Sleep Sci. 2015 Nov;8(3):134-42. doi: 10.1016/j.slsci.2015.08.003. Epub 2015 Sep 3.
The role of flow limitation as an important diagnostic tool and clinical finding in mild sleep-disordered breathing.
Arora N1, Meskill G1, Guilleminault C1.


Walt

[Sleeprider]

Want to see flow limitation? This is one of the more severe examples I have see posted on the board. This also is accompanied by a remarkable inhale:exhale ration of nearly 3:1. The person who posted this has gone on to bilevel, and I have not seen any followup from that change.

[wolson]

Want to see flow limitation? This is one of the more severe examples I have see posted on the board. This also is accompanied by a remarkable inhale:exhale ration of nearly 3:1. The person who posted this has gone on to bilevel, and I have not seen any followup from that change

There sure are a lot oh things going on here, and not all of it is flow limitation although that certainly is present. I am surprised the AHI is so low! There clearly will be a lot of RERA's so the RDI might be more pertinent here.

I would be interested to know BIPAP helped!

Walt

[Sleeprider]

He posted at the beginning of January he at returned the APAP and was scheduled for a bilevel titration. Has not updated since. The AHI was okay, but the RERA was pretty intolerable, and he had very high H in previous submittals. Anytime we see restricted inspiratory patterns like that, it usually helps to get on a machine with higher low EPAP and good pressure support to support better ventilation.