"please keep me updated about oximeters "
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BIPap RESULTS for response from experts please
OK,1st night that I used new machine and I can actually say I am NOT very tired today, used CPAP for 6 months NO RESULTS. So here is what I collected off resmeds auto bipap let me know what you think and what may be changed good or bad, I know nada.
LEAK 0.50L/S
VT 500-1020
RES RATE 12-19
MV 7.7 16.3
PRESS 18.8
AHI 20.1
AI 5.3
%SPERT C & T 0%
MACHINE IS SET ON 6 AND HIGH 19 WITH A 3 DIFF
LEAK 0.50L/S
VT 500-1020
RES RATE 12-19
MV 7.7 16.3
PRESS 18.8
AHI 20.1
AI 5.3
%SPERT C & T 0%
MACHINE IS SET ON 6 AND HIGH 19 WITH A 3 DIFF
Views: 684
Replies to This Discussion
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Permalink Reply by Judy on
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I'm a bit confused here. Just exactly WHICH Resmed device do you have? Do you have a VPAP (bi-level) OR and APAP (auto PAP w/expiration pressure relief)? Look on the top of your Resmed where it will say in the blue area above the screen which model it is or the cover of your Users Manual which will also say which device you have.
I have had the Resmed S8's: CPAP and APAP and I have what might be called a S8 1/2 VPAP Auto (this model came out in January and has already been replaced by the Resmed VPAP Auto 25 as of July 2008). The VPAP Auto 25 is an S8 II device.
The Auto would be called AutoSet Vantage (S8 which is what I have) or just AutoSet (S8 II). If a bi-level the model name would be VPAP Auto 25 (S8 II) or VPAP Auto (S8) or one of the even more sophisticated VPAPs.
After we know just which model you really do have we also need to know what mask you are using, or at least whether it is a Resmed mask or not and then also the Mask Selection setting you are using before we can say whether your Leak rate is acceptable or excessive.
Unfortunately, I'm just an apnea patient, not an RT so I can't tell you what ideal VT (tidal volume) is "normal" nor even what the "normal" Respiratory Rate is for comparison. The same goes for the MV (minute ventilation) and I've never seen the term "SPERT C & T O%. You either have an S8 II or a more sophisticated VPAP than I've seen any data from.
And I sure don't understand the settins of 6 w/a high of 19 w/a 3 difference. At least not w/a bi-level.
Those settings sound like an APAP w/a minimum pressure of 6 and a pressure range of 13 w/the top pressure setting at 19 and EPR (expiration pressure relieve set at 2 cms).
IF a bi-level you'd be talking an EPAP of 6, and IPAP of 19 and a Pressure Support of only 3?? With the Resmeds the EPAP controls the pressure fluctuations and w/a pressure support of 3 that would only leave 1.4 or 1.6 of pressure fluctuation.
Its gotta be an S8 II or one of the more sophisticated VPAPs!!!!
I can tell you that Tidal Volume = is the volume of air inspired (or expired) in one respiratory cycle (breath).
Minute Ventilation = the volume of air breathed in (or out) w/in any 60 second period.
Also, the allowed vent (or leak) rate built into these masks is always expressed in L/M (litres per minute) but your Leak rate is expressed in L/s (litres per second). So unless you are using a Resmed mask you would need to look at the literature that came w/your mask for a table of how many L/M is the allowed vent rate at your set pressure and convert your reported L/s to L/M to know your true Leak rate.
If you are using other than a Resmed mask then the proper Mask Selection would be the Standard selection. Regardless of your pressure the Standard Mask Selection deducts 0.4 L/s or 24 L/M from the reported Leak rate. If you are using a Resmed mask, then the Mask Selection should be set for that particular mask and the Resmed will automatically reduce the reported Leak rate by the allowed vent rate at your pressure and the reported Leak rate would be your actual Leak rate.
I know - all of this is clear as mud. But knowing exactly WHICH Resmed xPAP you are using and exactly which mask you are using plus the set Mask Selection we can clarify things for you. (I say "we" but it would fall to the RRTs or maybe RPSGTs here in the forum to explain much of this!).
I CAN say that your AI is still higher than would be most desirable and your AHI is way too high - but 1] Resmeds tend to score HIs more aggressively and 2] too high of a leak will throw your data out of whack and you would need to get your leaks under control before you will get much meaningful data that can be relied on.
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Really, jnk?? That's not the way the Resmed Rep explained it to me as the reason why I was getting no fluctuation in my pressure but a straight across the board pressure reading. Unless THAT is the reason they replaced the VPAP Auto w/the VPAP Auto 25 so quickly!!! Your explanation certainly makes more since because I fail to see any auto in this VPAP Auto w/the settings they originally made. And, remember, I have the software so I can see the graphs showing any fluctuation or not. Either that or I completely misunderstood him. Which is possible ..... but still leaves me wondering why they ceased production of and replaced my model of VPAP so quickly .... just 6 months???
Certainly what you are saying makes a LOT MORE SENSE!!!
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Permalink Reply by RockRpsgt on
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You guys are alot better at this end of it than me but my math works out the same way as jnk's.
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Obviouly, jnk is a LOT better at this than I am, Rock Hinkle! He's explained a LOT to me that has helped. But he's always cautioning me, he's just a patient too, and when the Resmed Rep explained it differently to me .....
Or maybe jnk just had a lot better way of explaining it than the Resmed Rep and I misunderstood him. I know back in high school my dad helped me w/my algebra and I had no problem understand HIS way of doing algebra but just could NOT grasp the way they were teaching it in school. But it wasn't enough for me to be able to easily get the correct answer dad's way, I HAD to get the answer right doing it THEIR way. So I'd whiz thru the problem's dad's way, then spend HOURS trying to come up w/the correct answer their way. *sigh* I managed a B but boy I had to SLAVE to do it!
When it came to geometry at the end of the first marking period my teacher gently told me he'd give me a passing D "if" I would transfer out of geometry and into another type of class. *red-face* I switched to shorthand. Which I also had trouble w/since I am left handed and have a "backward slant". I could read it but no one else could! My first year in school w/a C on my card, much less that d*mn D!!!! I was mortified!
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YES i HAVE AN EPAP OF 6 IPAP OF 19 with a 3 pressure support. THE NUMBERS are going to have to be done over again tonight for i made this mistakeI TOOK OFF MASK AND WENT TO BATHROOM WITHOUT SHUTTING IT OFF SO NUMBERS WOULD BE HIGHER. But yes I have a res med autp bipap 25 newest one with a full face mirage quattro mask those numbers of 6 19 and 3 sound ok or should I change the 3?
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Set tight w/those pressure settings on the Resmed VPAP Auto 25 and leave the Pressure Support alone as well for now. You/we need to have a better handle on your Leak rate. And ONE night of data does NOT tell the story. Leave your settings alone for least 7 nights of data. DON'T make ANY changes, not even a mask change for that ONE WEEK.
I recognize how tempting it is to play w/our new toys when we learn the "keys" but that isn't the smart thing to do. You have to be PATIENT. One week isn't forever. And you will have more data available to more reliably determine what pressure settings need to be changed. These fully data capable xPAPs are good - but they are NOT a full PSG being titrated by an RPSGT. In other words, they aren't THAT good! I wouldn't want to rely on just one night of data from a fully data capable xPAP. You'll end up chasing windmills.
I'm just a patient. Let's see what some of our pros suggest. Or even jnk, he's a pretty savvy patient I have a lot of respect for.
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Robert Cooper, could that %SPERT C & T 0% you listed actually be %SPONT C & T 0% ??
'Cause maybe that would indicate the percentage of spontaneous cycling and the percentage of spontaneous triggering??
The Clinicians Manual says:
% Spontaneous Triggering and % Spontaneous Cycling
Here's what your Clinicians Manual says about Leak rates.
Leak = Derived by analyzing inspiratory and expiratory airflows as well as expected mask
vent flows. A leak rate of more than 0.4 L/s (24 L/min) affects the accuracy of other
measurements and is associated with disturbed sleep, and reduced efficacy of
treatment.
I want you to know I am JEALOUS of all these extra options and data you have w/the VPAP Auto 25 as compared to my VPAP Auto!!!!. *sigh* *sob*
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yes I spelled wrong, that is it
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sir what is the meaning of without bilevel titration factory was set at 4 salesman changed to 3 for ps, so I thought it was starting at 6 epap and IF NEEDED by obstruction going up to 19 ipap, that wrong or bad?
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Permalink Reply by Duane McDade on
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You got a Bi-LEVEL Machine without a sleep study to titrate your Pressures??!!! I'm not surpized your AHI is that high. I can't believe that doctors hand these machines out like asprin samples!
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NO I had a sleep study, and I am new DO NOT KNOW WHAT IS TITRATE PRESSURES, if that is the 2 numbers they said a low and a high for blowing by obstructions at sleep if that is it they said it was 12 and 19, all I know.
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Sorry here it is the auto pressure setting 6-19 is way too wide for example 12-15 with a 3cm diff. would be much better. Its like the speed limit near a school is 10-70 miles per hour or 15-20 miles per hour......where do you want your kids?
robert cooper said:NO I had a sleep study, and I am new DO NOT KNOW WHAT IS TITRATE PRESSURES, if that is the 2 numbers they said a low and a high for blowing by obstructions at sleep if that is it they said it was 12 and 19, all I know.
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