Re: Is 18 too high?
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Re: Is 18 too high?


Posted by RPSGT2 on May 31, 2002 at 13:59:11:

In Reply to: Re: Is 18 too high? posted by SCNVSleep on May 31, 2002 at 11:37:15:

Good question, query. SCNVSleep, I've also wondered why manufacturers make CPAP's that go so high when it is extremely rare that a patient can tolerate those kind of pressures.

If a patient really needs that high of a CPAP pressure, usually we will switch to bilevel pressures and see how they do. Sometimes though, a person is able to tolerate high CPAP pressures at home although I believe I read once that the long-term compliance rate isn't very good.

Also, when titrating someone, it can't be stressed enough that a good seal is important. If the leak rises above 20 L/min at ANY pressure, our protocol is to adjust or change the mask. Mouth breathing is also very important to watch for since nasal CPAP isn't going to do much good if the patient has their mouth open.

We've had a few patients with severe OSA who have been sent for a T&A or even UPPP and then brought back into the lab after they've healed to be retitrated. Although this rarely cures their OSA, it will often allow them to tolerate a lower CPAP pressure.


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