"please keep me updated about oximeters "
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inventor of cpap
I'm so glad that Colin has avoided taking credit for inventing CPAP, because I INVENTED IT. I have photos from 1973 or 1974 of a jury-rigged device which I submitted to the AART (at the time) journal, and their critique about my placement of the proximal pressure monitor. Just thought you'd like to know
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Permalink Reply by Judy on
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Its interesting reading from your perspective, Scott. We tend to think of our own OSA/PAP situation and, I think, don't give much thought to beyond - those hospitalized w/various respiratory problems, etc. and how their "therapy" is related to our own. I appreciate your sharing.
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Great, hope these forums help. You are probably realizing that CPAP for OSA is emphasized more recently, 20-30 years, and super-emphasized last 10 years with Berlin scoring in pre-anesthesia. This pre-qualifies the patient for post op monitoring on these wonderful central oxymetry monitors which record and alarm warning of desaturations, and are the first real steps in studying a person's sleep habits. During the day our upper airway muscles are tense and toned as we talk, breath, eat, swallow. All of this changes when we sleep and all of those muscles relax and change the shape of our airway, usually smaller and flatter. The airflow then becomes turbulent and causes the soft tissue to 'flap in the breeze' or snore. In the extreme cases the soft tissues lay flat against themselves and block or obstruct the airway and you have OSA or obstructive sleep apnea, obstructive sleep disease. These obstructions are directly related to the amount of tissue present, in other words a thick neck by definition will be more likely to obstruct. Further tests in a sleep clinic provide much more detailed information on the patients oxygen saturation, ETCO2 (exhaled carbon dioxide), EEG, EKG, respiratory effort, ancillary muscle effort, diaphragmatic movement and on and on.
Judy said:Its interesting reading from your perspective, Scott. We tend to think of our own OSA/PAP situation and, I think, don't give much thought to beyond - those hospitalized w/various respiratory problems, etc. and how their "therapy" is related to our own. I appreciate your sharing.
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They can detect the exhaled carbon dioxide during a PSG??? I thought there weren't many ways carbon dioxide could be detected other than an ABG or a full PFT. What measures, or how is ETC02 measured, during a PSG??
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Interesting new thread at cpaptalk.com.
The concept was first presented in 1936!
"... Also, "bubble" CPAP generators should not be considered as being able to provide xPAP therapy in the home setting. They were (and still are) used to treat neonates. ...Next, we have the find the article where they were using bubble-CPAP generators. Data was presented in 1971 in
Gregory GA, Kitterman JA, Phibbs RH, et al. Treatment of idiopathic respiratory distress syndrome with continuous positive airway pressure. N Engl J Med 1971;284:1333. ...
... In 1936, Poulton and Oxon described their “pulmonary plus pressure machine,” which used a vacuum cleaner blower and a mask to increase the alveolar pressure and thus counteract the increased intrapulmonary pressure in patients with heart failure, pulmonary edema, Cheyne-Stokes breathing, and asthma." (Cleveland Clinic Journal of Medicine May 2010 vol. 77 5 307-316). ...
... the most common misconception is that CPAP is a type of machine, it is actually a mode of ventilation. Mr. D who has been granted the title of "The Father of CPAP", did not actually invent CPAP, he MAY have been the inventor of the "Home" CPAP machine, however that is debatable as well."
http://www.cpaptalk.com/viewtopic/t52288/Muffy-Invented-CPAP.html
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Permalink Reply by Walt Service on
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wow....Sorry Scott, but this sounds like a load of bunk to me; no offense though. I've only been in sleep for about 14years but here in NH, we've never heard hide/hair of you or your claim. That doesn't make you wrong, or your claims false...but hell when I clean the kitchen I sure in the devil make sure my family knows about it....If I had invented cpap, I would have been taking applause (and yen) for years.
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I couldn't find a date on the photo, but I found it and scanned it and it is in this thread somewhere, but it was from 1973 or 4 and we did use it successfully, and I did submit it to (AAIT) inhalation therapy at the time now that I recall, so it was nearly 40 years ago, and they did critique it, and other people came up with devices after that, maybe before that, I don't know. So believe what you will but it was really an offshoot of the poor man's IMV on the MAI before they built it into the ventilators. I don't recall that the early MAI's had PEEP standard, we had to buy a special valve that applied pressure to the exhalation diaphragm. So initially we just ran the exhalation through a water bottle with whatever amount of PEEP we wanted. We just applied the same gear to spontaneously breathing patients minus the ventilator. It worked. I suppose the research (evidence based) finally caught up and industry developed production models. I was never in that end of the business, I've been now 40 years in critical care. The first really great CPAP machines with all of the flow capabilities and fractional oxygen control that we really need for critical care was the Vision about 15 years ago or so, CPAP and BIPAP. Great readouts for the time, but like the MAI of 40 years ago set many standards and we still use them extensively today until it comes out in redisign with battery power I hope. There are some portable ventilators with portable BIPAP capabilities already.
Walt Service said:wow....Sorry Scott, but this sounds like a load of bunk to me; no offense though. I've only been in sleep for about 14years but here in NH, we've never heard hide/hair of you or your claim. That doesn't make you wrong, or your claims false...but hell when I clean the kitchen I sure in the devil make sure my family knows about it....If I had invented cpap, I would have been taking applause (and yen) for years.
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hi Judy, by PSG are you talking about polysomnography? If so, they do have in line and side stream CO2 monitors, some as small as pulse oxymeters, and resemble them. the side stream ones have a pump that draws exhaled gas from near the nose and/or the mouth and analyzes it and reports it as CO2. It correlates to what you might find if you drew an ABG at the same time. Of couse it is non-invasive and continuous, both preferable to the arterial puncture.
Judy said:They can detect the exhaled carbon dioxide during a PSG??? I thought there weren't many ways carbon dioxide could be detected other than an ABG or a full PFT. What measures, or how is ETC02 measured, during a PSG??
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Interesting, Scott. I assume they are not used any too often? Only for certain patients w/ known or suspected C02 retaining problems such as some COPD patients?
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Permalink Reply by 99 on
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hi scott
the interesting question is where have you been until now
probably books have been written and have given wrong information as to the inventor of cpap
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