Change Tidal Volume or target Alveolar volume

[jessicashriverhilliard]

Hi all, we picked up a used Resmed VPAP Auto and need to change the previous user's settings. I know how to access the main clinical menu, and have successfully changed the  IPAP, EPAP, etc.....but how do I change the machine's target alveolar volume (similar to the target tidal volume)? What menu is that on? Thank you!

-Jessica

[ajack]

I don't think it will have a Va, that is with the avaps on philips and ivaps on resmed machines. It seems you have the auto bipap. I would download the clinical manual from the top of the page. you could try changing modes cpap, S, auto, ivaps or whatever the modes are and see if IVAPS is shown.
If you give the model number, we can double check that for you. Initially I would do a factory reset, to get back to default settings and go from there.

[jessicashriverhilliard]

Thank you! We have the Resmed S9 VPAP Auto... is that what you mean by model number? I am new to this machine. I did check the settings menu and it does not have the iVAPs setting. So without this setting, the machine won't adjust to the patient's tidal volume? :\

[ajack]

That is correct, you can't preset the outcome, it has to be titrated with medical support. Depending what is wrong, the Vt can be adjusted by PS if it is appropriate. You should have your doctor set it up, it is a specialised field and I wouldn't take advice from the internet. Other than run of the mill general stuff.

The titration guide will give an overview of what the doctor will arrange, from page 21
https://www.scribd.com/document/35340282...-Titration

When the doctor has it set up, you might like to post charts for opinions

What machine did you have before, some of the settings may be able to be transferred until you see the doctor.

[Sleeprider]

Jessica, the only settings you should be concerned with are EPAP min, PS and IPAP max. The EPAP minimum pressure should be the pressure at which obstructive apnea are generally well treated (not present). Pressure support is used to resolve flow limitation and hypopnea, with a starting default value of 4-cm. If hypopnea remains present, increase PS, if centrals occur, decrease PS. The IPAP max or maximum pressure is the least important value. It must at a minimum be EPAP min plus PS, but to allow the machine to automatically increase pressures, it should allow some room to move; for example EPAPmin plus PS plus 5.0 cm.

The S9 VPAP auto has no backup rate and cannot be set to specifically target tidal volume or alveolar volume. There would be no need to do so unless there is a known pulmonary impairment. Other settings like Ti min, Ti max can just be left at defaults of 0.3 and 2.0 for now, and it would be impossible to advise without knowing more. For pulmonary issues, EPAP min is positive end expiratory pressure (PEEP) and ensures oxygenation, and pressure support provides for ventilation to flush CO2. TiControl’s Ti Max and Ti Min parameters play a role in maximizing synchronization by effectively intervening to limit or prolong the inspiratory time when required. This information and more is discussed in the Clinical Manual available from Apneaboard here: http://www.apneaboard.com/adjust-cpap-pr...tup-manual

[trish6hundred]

Hi jessicashriverhilliard,
WELCOME! to the forum.!
Good luck with your new machine and getting it set.