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They gave me the wrong machine !!
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11-27-2017, 05:09 PM
They gave me the wrong machine !!
So, I go to the VA this afternoon, and at first, before looking at my data, the respiratory tech tells me " it's common to have central apnea for the first few months", and I'm thinking "oh God; here we go". Then she looks at the data, starts saying " hmm, that's not good", then looks at the sleep study and says "oh wow!", then notices that the doctor had put in a STAT order for the Aircurve 10 ST-A, and the traveling tech had given me the Vauto. Boy, they were P*ssed! They called up the medical supply company and told them that they needed to make this right tonight, and sure enough, I was able to stop on my way home and pick up the new machine. Yay!
RE: They gave me the wrong machine !!
You will really like the st-a, It's a great machine with ivaps, that will give nearly a straight line on your minute ventilation. Who is titrating it with you?
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
11-27-2017, 05:34 PM
RE: They gave me the wrong machine !!
So we have an error! I remember discussing your titration results and was shocked at the dispensing of the VAuto when the best efficacy was shown with ST-A. That said, my recollection is your best result was an AHI of 6. I think you may still need ASV, but this should be a lot better.
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
11-27-2017, 08:18 PM
RE: They gave me the wrong machine !!
There may have been one of the contraindications to exclude the ASV. The ASV is a lot cheaper than the ST-A. It's something that could be talked about at the next appointment.
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
11-27-2017, 11:36 PM
RE: They gave me the wrong machine !!
Thanks, guys! I have some questions. Machine is hyperventilating me!
11-28-2017, 09:16 AM
RE: They gave me the wrong machine !!
We talked about the drawbacks of the ST machine at some point...it uses the same pressure support with a backup rate all the time. For someone with central apnea, this actually causes you to have more centrals and more reliance on the ST pressure support to cause breaths. Contrast this with the ASV which can use a minimum pressure support of zero and applies pressure support as needed, when needed.
What are your settings? EPAP, IPAP, BPM?
Sleeprider
Apnea Board Moderator www.ApneaBoard.com ____________________________________________ Download OSCAR Software Soft Cervical Collar Optimizing Therapy Organize your OSCAR Charts Attaching Files Mask Primer How To Deal With Equipment Supplier 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.
11-28-2017, 10:32 AM
RE: They gave me the wrong machine !!
(11-28-2017, 09:16 AM)Sleeprider Wrote: We talked about the drawbacks of the ST machine at some point...it uses the same pressure support with a backup rate all the time. For someone with central apnea, this actually causes you to have more centrals and more reliance on the ST pressure support to cause breaths. Contrast this with the ASV which can use a minimum pressure support of zero and applies pressure support as needed, when needed. Here are the settings: IPAP 15, epap 8, iBR off, backup rate 12 (I dialed it back to 9, but that didn't help much),Timax 2.7s, Ti min 0.3s, rise time min, trigger medium, cycle medium, I set the ramp settings from off, to ramp time 30 min, ramp down on, start epap 5.0, all alarms off except alarm vol test medium, essentials plus, confirm stop and smartstart off, desat rule 3%. I will try to get my script. |
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