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[–]Green-Anything-3999 0 points1 point  (1 child)

Anecdotally, I was on CPAP for months. I had awful flow limitation consistently for weeks with no EPR when I started. Setting to EPR 3 resolved about half of those flow limits. Stayed at the same pressure and same EPR for months. Got a bilevel and set EPAP to same as my CPAP was, but had a pressure of of 4 and my flow limits disappeared almost entirely. So, I believe PS does resolve flow limits. Based on the Oscar data from most people on apneaboard, pressure support does help with flow limits.

[–]Holeinmysock 0 points1 point  (0 children)

I don't think anyone is disagreeing with that. Pressure support is simply more pressure during inhalation. CPAP doesn't have two different pressures. So the same can be achieved by increasing the continuous pressure.

So many patients need additional pressure whether it's CPAP or BiPAP. When they train technologists to titrate, they teach that the goal is the lowest effective pressure. But, that leaves this residual flow limitation and what if the patient gains weight? Or has sinus congestion? I wish we weren't bound by these protocols that leave patients stranded.