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Plmnb - the journey continues now with ST-A.
#11
RE: In anticipation of my BIPAP Re: New Thread
Currently set on Ivaps.

Target pt rate is set at 15.
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#12
RE: In anticipation of my BIPAP Re: New Thread
Hi Phoebe. I've been cutting a subfloor for my daughter to install new wood floors on, so was away for a while. Slowriter linked to my previous post with setting recommendations. As I said there, I anticipate you want iVAPS mode. The T mode that your machine arrived in affords no spontaneous breathing at all. The IPAP triggers and cycles on a timer. I think we can do much better.

Set the mode to iVAPS. We need an EPAP that prevents most OA events. Based on your experience, the lowest pressure that keeps OA events to less than 2/hour would be fine. I am guessing this is between 10 and 14 cm-H2O. As I recall, we tried lower pressure way back when, and that didn't work out so good. So review your results and let me know what you think. My suggestion is to use PS min of 4.0, PS max of 20.0 or whatever you can set. You need to enter height and your normal breath rate (15 bpm?) and the machine will calculate Va (alveolar volume). We can set TiMin to 0.7 and Ti Max to 1.8 to 2.0 and rise time to 300 ms.

Let me know what questions you have and remember we are kind of discovering this together. My suggestions are mostly based on your past therapy.
Sleeprider
Apnea Board Moderator
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____________________________________________
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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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#13
RE: In anticipation of my BIPAP Re: New Thread
Either the people setting up your machine or doctor specifying how to set it up don't have a clue what they are doing. IPAP of 20 and EPAP of 6 is PS of 14 which would cause problems if you used it as such... 

In iVAPS I think you should set target ventilation a bit lower than it calculates as you don't need true ventilation support, you just want it to work harder at times when you are having those moments of crazy flow limitations. If it was me I would determine this value by looking at your OSCAR data and setting ventilation just below what appears to be your average minimum ventilation. If you have data at a lower PS of 4 that might be good to go off.
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#14
RE: In anticipation of my BIPAP Re: New Thread
She has it set at 6, which happens to be just a bit below the median on the VAuto.

She's fine.
Caveats: I'm just a patient, with no medical training. And my first experience with xPAP was fairly recent. So I'm somewhere along the path of a steep learning curve.
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#15
RE: In anticipation of my BIPAP Re: New Thread
Hi Sleeprider.  Just awoke from a nap and saw your post.  Thank you for your reply.  (Hope the sub floor bit goes well).

I think I got them where you pretty much suggested.  I split the difference a bit on some.  And one of the settings won't go any higher so I left it at the highest, I think that was Max PS?  I looked up my vitals on my health app from the doctor and the last bunch of BPM was 18, so I used that figure.  Height only is adjustable by 2 at a time.  So I wasn't sure if I should go higher on my height or lower? My true height is 5 foot 2 3/3 inches.

Therapy

MODE:  iVAPS

Height: 64 Inches

Target Pt Rate: 18

Target Va: automatically set I think

MV, Vt, Vt/Kg: Can not do anything to settings

EPAP: 12.00

Min PS: 4.0

Max PS: 18.00

Ti Max: 1.9s

Ti Min: 0.7s

Rise Time: 300ms

Trigger: Med

Cycle: Med

Do I need to change any of these?  Should I worry about the Learn Targets bit?  Also, I will be requesting the clinicians manual, have not had a chance yet.  Hopefully tomorrow.  Pretty sure it will be greek to me though.

Excited to hear back...awaiting a decent night of sleep!  Big Grin

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#16
RE: In anticipation of my BIPAP Re: New Thread
Was that 18 bpm you mention while awake, or asleep?
Caveats: I'm just a patient, with no medical training. And my first experience with xPAP was fairly recent. So I'm somewhere along the path of a steep learning curve.
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#17
RE: In anticipation of my BIPAP Re: New Thread
Settings look fine, and your initial trials should tell us if you need changes. I don't expect the breath rate to be a factor unless flow limits really slow down your respiration rate to less than 13 BPM (iBR minus 5). Relax, sleep well. This will be interesting.

Let me know if you want me to split the ST-A therapy to a new thread.
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.
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#18
RE: In anticipation of my BIPAP Re: New Thread
Getting closer!!!

Yes, the BPM was while awake.  I think I’ll give this number a try, at least for tonight.

I think it would be for the best to split the thread.  Are you able to add/change the title to:  Plmnb - the journey continues now with ST-A.

I’d appreciate it Smile

PS. Just in time too.  Last night the Trash Compactors Galore!!
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#19
RE: In anticipation of my BIPAP Re: New Thread
But you want BPM while asleep.

On your VAuto, was 16.
Caveats: I'm just a patient, with no medical training. And my first experience with xPAP was fairly recent. So I'm somewhere along the path of a steep learning curve.
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#20
RE: In anticipation of my BIPAP Re: New Thread
Some info in case target values are hard to set; there's a learning mode on the ST-A that takes about 20 min to set-up. It would address target values automatically according to the manual on page 23.

Learning mode purpose: Learn Targets monitors the patient’s resting ventilation, with the goal of learning the patient’s Target Alveolar Ventilation (Target Va) and Target Patient Rate (Target Pt Rate) in preparation for iVAPS mode.

See here

   

   
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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