(01-17-2015 11:11 AM)leiko49 Wrote: Just Mongo,
The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.
I now have possession of the manual, and indeed the additional PS can be set to zero.
I was able to set the min ps to 0, and the max ps to 5 (the lowest setting it allowed me).
If I do this, will the machine function virtually like an auto bilevel? I ask this question because I do not follow all of the complex scientific description you had shared. Beyond my area of expertise.
To answer your question, no.
What justMongo meant by the "additional
Pressure Support" which is added by an ASV machine if we stop breathing was not the Pressure Support itself but the difference between the Min PS and the Max PS
settings. If this difference is zero then Min PS and Max PS will be the same number, and if we stop breathing the ASV machine would be able to start cycling between EPAP and IPAP but the machine would not be able to also increase PS.
If the Min PS and Max PS could have been adjusted to the same non-zero number (on the PRS1 BiPAP autoSV Advanced the Min PS and Max PS can be set to the same number, but not on the ResMed ASV machine because its Max PS must be at least 5 higher than its Min PS) then when an apnea starts the machine would not be able to increase or decrease PS but would still be able to start cycling between IPAP and EPAP, like an ST machine would be able to do. Additionally, the BiPAP autoSV Advanced machine would still be able to automatically adjust EPAP, making the machine function as an Auto ST machine (meaning, an auto-titrating bi-level machine like the A10 VAuto, except with a backup rate).
When you return the machine
(it does not include the prescribed therapy mode and would not be covered by insurance) get your doctor to change your prescription to include a heated hose. I suggest not accepting a machine unless it has a heated hose.
The PRS1 BiPAP Auto With Heated Tube (model DS760TS if in the U.S.A.) has features which the S9 VPAP Auto and the AirCurve 10 VAuto lack. The BiPAP Auto reports RERA events. It also is able to (very slowly) vary PS within a range in order to minimize Flow Limitation. It also has Bi-Flex which is able to add additional exhalation pressure relief which is Flow based (BiFlex is in addition to the pressure relief produced by EPAP being lower than IPAP), so that the stronger you exhale the more additional pressure relief is provided (the pressure drops below the EPAP setting while we are actively exhaling and settles to the nominal EPAP pressure during the slight pause before the start of inhalation).
The "AirSense" and "AirCurve" models are new and easily confused, and "bi-level" is often confused with "bi-level with backup rate" which is the classification for machines like ASV and ST machines which treat apneas by cycling between IPAP and EPAP at a backup rate. So it could be that the person who dispensed the ASV machine did it by mistake.
(01-17-2015 11:17 AM)Sleeprider Wrote: Consider what is likely to happen when the DME submits an invoice to insurance, where the diagnostic code does not fit the dispensed (much more expensive) equipment. Someone is going to get rejected, and it's likely to land in your lap.
(01-17-2015 11:51 AM)justMongo Wrote: I have to agree. The OP's description of his Rx script clearly does not intend for an ASV to be dispensed. Whether by accident or intentional, the wrong machine was dispensed. (I suspect ignorance by the dispensing technician.) leiko49: You should take it back to the DME and get the machine that complies with your Rx.