Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

My Journey from BiPAP Auto to Aircurve 10 Vauto
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Last night 3 ca no other - good night.  I taped my mouth and I am sure no mouth breathing but the graph still shows a flat top on leak rate.  I go into the lung Dr. Next Monday and would like to know as much as possible before talking to him.  Could someone please look at these graphs and tell me why the Leak Rate is the way it looks?  Thank you for your time and input.  pictures: Full night, closeup of low o2, closeup of high o2.


Attached Files Thumbnail(s)
           
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply






Donate to Apnea Board  
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Stacey, your desaturations correspond to periods of low tidal volume and higher leaks. You are spontaneously breathing, but just not generating a lot of flow with each breath. The only tool I know to get more volume is to take your PS to 5.0 and see if there is any improvement. When we changed from 4.0 to 4.4 you gained about 30 mL of volume, so increasing PS may help.

I'd like you to post one more graph with showing flow rate, tidal volume, SpO2 and inspiration time. We may try increasing the minimum inspiration time (Ti Min) setting if short inspiration time also correlates with low SpO2. Let me know what your current setting for Ti Min is.

A couple things to note for your doctor. We have intentionally kept your minimum EPAP pressure relatively high to act as "positive end expiratory pressure" (PEEP). This this technique is commonly used in ventilation to recruit lung volume. We don't need EPAP at 9.0 to prevent apnea in your case, so this was a judgement call. I have previously calculated your FiO2 using the full capacity of your oxygen generator and assuming 35 L/min flow from the Vauto based on the intentional leak rate of your nasal mask. When leaks occur, the flow from the Vauto becomes greater and the FiO2 will drop significantly. I will copy the estimates below, and you may want to share this information with your doctor. We can only do the calculations, and cannot judge what your targets should be or even recommend changes in therapy, but your doctor can decide if a second O2 generator may be needed. Nothing on the forum should be construed as medical advise, and you must work with your doctor to determine the appropriate course for your treatment. Your Vauto therapy is very effective in preventing apnea and providing comfortable sleep disordered breathing therapy, however you have complications with oxygen saturation and respiration volume that exceed our ability to help.

Determination of FiO2 (fraction of inspired oxygen) with CPAP:
FiO2=(Oxygen L/min x 100%) + (Vcpap L/min - Oxygen Flow L/min) x 21% O2) / Vcpap
where:
Vcpap = Design flow of mask at pressure

FiO2=(5-L/min x 100%O2) + (30-L/min x 21% O2) = (500+630)/35 L/min = 32% oxygen at the mask in a leak-free circuit.

If your excess mask leaks increase to 25 mL, the total flow of the circuit increases to approximately 50 L/min, and FiO2 drops to only 28%, so controlling leaks is important, and you can see the impact of leaks in your chart on the SpO2.

A second oxygen generator at 5 L/min will result in a FiO2 of 43.6% in a leak free circuit.
FiO2= (10 L/min oxygen flow x 100%) + ((35-10) L/min x 21%) / 35 L/min = 43.57%

Link to wiki: http://www.apneaboard.com/wiki/index.php...circuit.3F
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
THANK YOU for your help! My settings:
Max IPAP 20.0
Min EPAP 9.0
PS 4.4
ti Max 2.0s
ti Min 0.3s
trigger high
cycle Med

Here are the graphs you wanted, if you need more or I did not do them right let me know.  Again thank you!


Attached Files Thumbnail(s)
       
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Let's try Ti Min at 1.0. If that feels too pushy, back off to 0.8 We can see periods of desaturation sometimes result in inspiration time less than 1-second.

By far the biggest influence on desaturation is periods of large leak. Bonjour was talking to me about how moving the O2 feed to a nasal cannula mounted through the mask, but we have not come up with how to accomplish that. He used to do EMT work and getting oxygen closer would likely make a big difference, even with a large leak. Maybe your doctor has an idea on how to do that. The best we came up with is penetrating the mask pillow with a tube or the nasal cannula and sealing with silicone putty. If you have extra pillow cushions around, maybe you can McGyver something.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Thank you I will make changes tonight, and might try to come up with something with an old mask!
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
My thought was with a nasal or FFM that some O2 tubing and nasal canula would fit. drill a hole that would be a tight, friction fit the O2 Tubing thru it, sealing with putty if needed, not worried about the straps as they usually are flat. An O2 to O2 tubing connector on the outside. When trying this wear a oximeter and compare the differences. O2 Sats should go up, but like SR said we are not doctors .
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Ti Min at .8 - started at 1 but just seemed to have a hard time breathing.  I think it looks better but the time my O2 was down it looks like shallow breathing, I don't know why...


Attached Files Thumbnail(s)
       
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply






Donate to Apnea Board  
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Mixed results in my opinion. We see tidal volume and minute vent has dropped, but respiration rate is increased. These are exactly the opposite of the intended result, however your SpO2 appears improved. I still want you to increase PS to 5.0 and have mentioned this at least three other times. Let's reset your Ti Min back to default 0.3 and move PS to 5.0.

Any progress on fitting a cannula into the mask?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
Ok I will. Thank you
Not yet the silicon did not do a very good job, leaks. I'm sorry about the PS setting, I did set it but I must have just dialed it up and did not press the button to save it. I made both changes and went back to see if the settings were correct. Again, thank you for your help, I'm sorry I screwed it up.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply
RE: My Journey from BiPAP Auto to Aircurve 10 Vauto
This is the only mask I can find that has an air port built into the mask.  I can't sleep on my back so I'm not sure this one will work.


Attached Files Thumbnail(s)
   
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Resmed Aircurve 10 VAuto SD card type happydreams 9 111 1 hour ago
Last Post: SarcasticDave94
  [CPAP] Newbie would like some advice (Aircurve 10 VAuto) leancomfort 8 198 10-19-2020, 04:48 PM
Last Post: leancomfort
  What settings should I start with? (Self titrating a Resmed AirCurve 10 Vauto) sleepy331 6 140 10-17-2020, 02:40 PM
Last Post: bonjour
  SD card not working on my ResMed AirCurve 10 Dandur805 12 231 10-17-2020, 02:09 PM
Last Post: jaswilliams
  [split]AirCurve 10 CS PaceWave Analysis Request Bolsen 31 775 10-16-2020, 12:48 PM
Last Post: SarcasticDave94
  CPAP VS BIPAP ISSUES Politronics 1 117 10-13-2020, 05:24 PM
Last Post: SarcasticDave94
  What is a Dreamstation BIPAP AVAPS?? Who needs one? racprops 10 188 10-10-2020, 02:17 PM
Last Post: SarcasticDave94


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.