runningbare wrote:For therapy, the pressure MUST be set for only a few cm H2O below and above the titrated pressure...When an APAP pressure band is set too broad, and the lower end is set too low it doesnâ€™t oxygenate the blood enough.
runningbare wrote:APAP runaway is cured by lowering the upper pressure limit.
I don't believe the study is flawed.
This is the very first study, of course it has a low n number, that is how preliminary studies are done....I also have the study. It is the first study ever looking at the cardiovascular effects so of course there are no other studies. They can't cover all the variables at once. This study is called "Proof of Principle" a seminal study to suggest further study which the researchers say, even in the abstract, they will be doing.
That any equipment over a year old is outdated may be false. I called ResMed technical service a few months ago and their algorithm had not changed since the first AutoSet T. I haven't checked with ResMed and Respironics since then and don't have time to so someone else feel free to call technical service for me and ask if and when the algorithms have changed.
A quote from my previous post:
"I would find it more interesting if they find that only one APAP shows decreased cardiovascular benefit. Wouldnâ€™t it be interesting to learn why the algorithm of that one brand of APAP doesnâ€™t function as well to prevent cardiovascular effects of OSA if indeed that is the case? Finding that all APAPs do not decrease cardiovascular risk would be boring and a serious blow to APAPs. Then again, maybe their results will not be repeatable. That is the basis of scientific inquiry, results must stand up to scrutiny and they must be reproducible."
Just because a paper is the first paper ever published on a subject does not mean it should be discounted. I didn't say this is the final word, please reread my post. I, in fact, said it wasn't the final word but a subject to watch. Scientists have to keep an open mind. As a scientist, far to often I see people discounting good theories and hypothesis just because they do not fit conventional wisdom and/or it isn't what they want to hear.
I do like your theory, it makes sense, and I will be interested to hear if, when and how algorithms have changed.
runningbare wrote:The fact is this study is being used as the basis for denying APAPs to people who could use their features, some of whom will die as a result. A doctor should not publish a document that is unverified and that causes harm. As far as I'm concerned this a violation of the doctor's hypocratic oath.
runningbare wrote:If this is study's results are so earth-shattering, why has another verifiying study not been done? This study was funded in 2003. Was it completed in 2003? If so, why did it take so long for it to be published?
runningbare wrote:It makes me angry when researchers who should know better interpret study results to justify their actions or agendas.
Viki wrote:I called ResMed technical service a few months ago and their algorithm had not changed since the first AutoSet T.
Resmed wrote:US Patent # 6817361 (2004)
The present invention will correctly increase the CPAP pressure for most closed airway apneas, and correctly leave the CPAP pressure unchanged for most open airway apneas.
Viki wrote:That any equipment over a year old is outdated may be false.
manuel wrote: The S8 AutoSet Vantage utilizes technology addressing central apneas not available on Autoset T:
Vicki wrote:Manuel, thank you so very much for providing me with the infomation to prove my point. You should at least read the abstracts.
Vantage Clinician's Manual wrote:The pressure will not rise above 10cm H2O when an apnea is detected, to prevent an inappropriate response to central apneas.
Patent 6,817,361 wrote:
In the above implementation, apneas can only cause the CPAP pressure to rise as far as 10 cmH.sub.2 O, but subsequently, indicators of partial obstruction can increase the CPAP pressure to 20 cmH.sub.2 O, which is sufficient to treat the vast majority of subjects.
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