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PRS1 Auto BIPAP, Starting Prisma ST machine
#21
RE: Switched from Philips respironics machine to Prisma 25 ST
Arnie, I merged your new thread with the ST with your previous thread about the Respironics Auto BiPAP because without the background of your mother's medical conditions and experience with the BiPAP, your questions were impossible to answer. We try to keep therapy threads together so we don't lose the history and therapy results.

The ST is a bilevel machine with timed backup. Bilevel therapy is generally more comfortable and is capable of assisting respiration, so this machine is a higher level of therapy than the Philips Auto BiPAP and should be able to overcome a number of problems. Your mother has respiratory failure, and the ST is capable of assisting each breath with pressure support, and to maintain the respiratory rate when she does not spontaneously take a breath. We need to know what the pressure and ST timing settings are in order to begin to judge how this machine is working. The ST is an appropriate machine for respiratory failure, but there are higher levels of devices like the Resmed Aircurve 10 ST-A which is much more intelligent and provides adaptive pressure support that changes on every breath to maintain the respiratory volume and rate using an algorithm called iVAPS (intelligent volume assured pressure support) and iBR (intelligent breath rate). The Prisma ST is an older technology using fixed IPAP and EPAP pressure and a timed backup rate. It cannot change those parameters to meet respiratory objectives.
Sleeprider
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#22
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
First of all thank you so much. I really appreciate the detailed and prompt response.

The Pressure settings in Philips Auto BIPAP were Min EPAP 6 MAx IPAP 15 Min PS 4 Max PS 8

In Prisma 25 ST this was set to EPAP 5 -7 and iPAP 9 -12 Apparently there is no concept of Pressure support

Another thing the Joyce mask which came along with the machine didnt suit my mom. So I am still using the Ivolve mask with the Prisma ST.

Incidentally is the Ivolve Full Face mask F1B full face mask a ventilated mask and is it suitable for BIPAP therapy at home?  [Commercial Link Removed] Search for: bmc f1b full face cpap mask

Once again thank you for your support.




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#23
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
On the PS aspect, this is the difference between EPAP and IPAP. You listed EPAP of 5-7 and IPAP of 9-12. The math part is EPAP 5 plus PS 4 equals IPAP 9 at the minimum. EPAP 7 plus PS 5 equals IPAP 12 for the maximum.

In other words, according to the EPAP and IPAP numbers, PS ranges from 4 to 5, as that's the only way the math works to get the IPAP stated. At least that's how the math works in determining PS on my ASV.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#24
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
It's interesting that the Prisma ST has auto-adjusting pressure. It sounds like it maintains PS 4 through the set range. Hopefully you can find some software to monitor the efficacy of that therapy. The only other thing I can think of is to consider having a recording pulse-oximeter to ensure oxygen saturation is being met. There are a number of units that can be worn overnight and you can download the results and verify SpO2 and pulse rates are good.
Sleeprider
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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.
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#25
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
Thanks so much. Could you please help me find out whether the mask I bought BMC Medical Ivolve F1B full face mask has vents or not? I can see 2 holes in the elbow. Is that the place where the exhaled air will come out? I am confused because the mask I rented had holes on the sides of the nose piece for the exhaled air to go out. I need to return this and as replacement I bought the full face F1B mask from BMC medical. I dont see the same Ventilation holes in this model. So am worried whether if I use this my mom will be breathing in her exhaled air! I have raised it with the supplier but silence so far, so if you can help I will be most grateful
Many thanks once again
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#26
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
Based on all the images I can find, you are describing the "F1A" model and not the "F1B".
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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.
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#27
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
My understanding it doesnt maintain. it simply goes up to the set Max IPAP. The reading of the SD card is also a process you need to have a SD port, then download the file send it to the distributor and he will send a readable file back which I have to send to the Doc. I have invested in it quite an amount of money so will stick with it.

I feel that after the change my Mom's day time sleepiness has increased BTW she never sleeps when the mask is on!!!!!

Saturation remains at 92 with 5 hours of BIPAP therapy and 1 ltr of Oxygen per min.

Again thank you so much for your responses. Really calms me down when I am talking with someone.
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#28
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
I am trying on today and will send an update later tonite.

Thanks
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#29
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
F1B assembly after cleaning was a bit of a pain. The thin pad and cushion 2 components do not fit in easily and after much trial and error went in
The strap is for a really large head and it almost comes around my mom's head.
There was Warning in the user manual which said do not use without the rebreathable valve is in place and there is no further details has me worried!
Nose piece has only a horizontal adjustment and not vertical
Ventilation holes work fine
Some amount of noise and had to really tighten it around my Mom's head looks like there is no way to buy a correctly fitted mask. These days because of COVID demo masks are stopped
Might be strange to you but where I am there is really no technical support other than you have to adjust a bit!
With all this my Mom has been wearing the F1B full face mask for 4 days and seems to be working touch wood
However if you have a choice go for a even lighter one which can be assembled and disassembled easily Also the strap clips are a bit clunky. Philips blue gel was good for this but was cutting the nose and size never fit even though that was a medium as well. Like pants look like many definitions of medium
Hope this is helpful
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#30
RE: PRS1 Auto BIPAP, Starting Prisma ST machine
Posting here as to continue history. Thank you for all your help and responses. It has been a great help. I have another question surprise surprise

My mom is fairly immobile and has been on 1 ltr Oxygen and BIPAP therapy for 5 hours a night. She is also nebulising once a day. With this her Oxygen level hover around 89 to 94. My question is without going through the pain of the Blood Gas test is there a way to find out if the therapy is helping? AHI 3. She is becoming weaker complains of stomach issues and doesnt sleep at all with the mask on. Going to the hospital is not an option currently. Any tips suggestions advice will be gratefully received
Many thanks.
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