Is one triggering mechanism better in severe restrictive lung disease with chronic carbon dioxide retention?
I’m not aware of any data to support a bias toward one trigger mechanism; however, a recent abstract presented at 2001 ATS meeting showed that flow-triggered pressure support devices tended to shorten the inspiratory time when connected to a restrictive lung model. Conversely, inspiratory time was prolonged when connected to an obstructive lung model, the worst thing to do for these patients. We hear from restrictive patients who complain of waking up short of breath and feeling suffocated. VPAP has a unique setting called IPAP Min that allows clinicians to set a minimum inspiratory time for these patients. The IPAP Min feature is active for both spontaneous and timed breaths (for S/T mode). Other devices have a timed inspiration setting, but this is for timed breaths only. IPAP Min has been very useful in restrictive patients in helping to assure consistent volume delivery even in deep stages of sleep. During the day I use two liters per minute of oxygen, which is fed directly to my n
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