Are fullface masks better for ASV?

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Are fullface masks better for ASV?

Postby LadyCandy » Sat Dec 11, 2010 4:15 am

I know Resmed recommends it specifically for their ASV machine, while respironics says any mask used for CPAP will work for AutoSV.
So I guess I'm wondering, smarter and wiser dinosaurs, IS a fullface mask better on ASV and why?
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Postby JCodling » Sat Dec 11, 2010 4:48 am

Well you know I'm no dinosaur but I have had better luck with triangle nasal masks. Most other techs have told me that you have to use a full face but I think whatever works and is comfortable for the patient is your best route.
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Postby strawberri » Sat Dec 11, 2010 6:15 am

Husband started out with full face with his ASV treatment, but he was used to using a nasal mask and went back to it after a week. However, his pressures are very high, and the alarm was constantly going off on the machine, so now he wears a chin strap also.

Whatever works best for them will encourage compliance, but make sure these patients have their alarms set on the machines at home...so they will know when they are leaking and can adjust accordingly.

The DME's in this area are really notorious for turning off the alarms, according to them it cuts down on phone calls at 2am....so I educate our patients about why the alarm systems are important and how to correct the leaks before they leave the lab. Our Medical Director specifically requests the alarms be turned on. It's all new to the patients and may frighten them the first couple of times at home...but if the time is taken to educate them by the DME's or the techs, compliancy is higher...at least for us.

That's my 2cents anyway.
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Re: Are fullface masks better for ASV?

Postby A New Convert » Sun Dec 12, 2010 4:06 am

LadyCandy wrote:I know Resmed recommends it specifically for their ASV machine, while respironics says any mask used for CPAP will work for AutoSV.
So I guess I'm wondering, smarter and wiser dinosaurs, IS a fullface mask better on ASV and why?



IMO a FFM is never better for anything, but that is well documented on this forum.

Don't tell ResMed but their swift mask works just fine of ADAPT too....


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Postby polysomnotech » Tue Dec 21, 2010 8:26 pm

Could they just be thinking that the added dead space would benefit the typical ASV patient, and thereby help to more quickly level out the flow pattern? I can't think of another reason off the top of my head... It wouldn't have anything to do with detection, would it?
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Postby linuxgeek » Tue Dec 21, 2010 11:02 pm

I'm pretty sure that they advise a FFM, so that they can be sure to capture all the patient's ventilation.

If some of it is escaping out the mouth, then it will throw off their calculations and who knows what it would do in those cases.

My opinion, in almost all cases:
FFM = FAIL

Beyond the notion that nasal breathing is much preferred, I'd bet dollar to donuts that the bottom portion of the mask is counter-acting the pressure support. I often see things on FFM, that I could never find an example of on a nasal mask.
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Postby Onesight1 » Tue Dec 20, 2011 6:20 pm

I've had no problems with using a NASAL mask + chin strap during an ASV.

I really hate FFM, so I only use them if absolutely needed
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Postby stars » Thu Dec 22, 2011 6:34 am

linuxgeek wrote:I'm pretty sure that they advise a FFM, so that they can be sure to capture all the patient's ventilation.

If some of it is escaping out the mouth, then it will throw off their calculations and who knows what it would do in those cases.

My opinion, in almost all cases:
FFM = FAIL

Beyond the notion that nasal breathing is much preferred, I'd bet dollar to donuts that the bottom portion of the mask is counter-acting the pressure support. I often see things on FFM, that I could never find an example of on a nasal mask.

I think you point FFM = Fail very extreme.
Not for all patient nasal mask with chin strap can help.
Nasal mask absolutly number one choice ,but i not claime FFM its fail
Just prove your point and i think in your lab tech use FFM
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Postby linuxgeek » Thu Dec 22, 2011 6:32 pm

I agree it was extreme. But mostly true.

IMO, FFM should be the last resort.
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Postby Rocklandish » Sat May 11, 2013 4:32 am

Are they still recommending FFM?
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Postby somnonaut » Sat May 11, 2013 7:12 am

I have queried my Resmed Clinical specialist for an answer.
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Postby Rocklandish » Sat May 11, 2013 8:54 am

somnonaut wrote:I have queried my Resmed Clinical specialist for an answer.


I haven't heard this in a while. One of our scorers questioned a co-worker as to why she did not use a FFM. I looked over the study and found very little issue with the mask. Some minor lip purging in REM. The leak was less than 2 for most of the night. Ill take a 2 on any machine any night.

Good to hear from ya, Claude.
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Postby somnonaut » Sat May 11, 2013 5:42 pm

I've been here, where have you been?
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Postby Rocklandish » Sat May 11, 2013 11:26 pm

I have been around. I needed a little break from the sleep sites. Someone recently reminded me of where I needed to be.
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Postby bduce » Sun May 12, 2013 12:55 am

While I have my preferences, in the end the best mask will be the one the patient can use with minimal to no leaks. Leak will affect the efficacy of the servoventilation algorithm.

As for pillows with the resmed device, previous vpap adapts (in the S7 shell) did mention pillows as not recommended but the new S9 version does specifically allow for pillows. Usually it means that in previous versions pillows was not necessarily contraindicated for use but rather they have not specifically tested the algorithm for the smaller dead space associated with pillow systems. They have since performed the testing and appears to work well.
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