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+--- Thread: Titration with a Resmed AirCurve 10 VAuto - would this work. (/Thread-Titration-with-a-Resmed-AirCurve-10-VAuto-would-this-work)
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Titration with a Resmed AirCurve 10 VAuto - would this work. - KeepSmiling - 11-02-2022
Will these settings work like an auto CPAP set to 7-20 cm and EPR off to do a titration.
IPAP 20
EPAP 7
PS 0
EPAP is set to 7 because using a full face mask.
I am assuming since PS=0, TiControl and Triggering do not come to play.
This is not for me.
--- Does the AirCurve 10 VAuto keep breathing pattern in memory? If different people use it will it mess the breathing in memory if kept.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - Crimson Nape - 11-02-2022
Since it isn't for you then, You are correct! (
Sorry! - I couldn't resist) Most adults feel air starved below a setting of 7 cm.Your followup question - No, its pressure pattern is in real time.
- Red
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - KeepSmiling - 11-02-2022
Thanks Crimson Nape.
I plan to set minimum to 7 because of a FF mask.
I recently turned a machine on that started at 6. Yup, not enough air. I changed the setting to FF mask and the machine went to 7 minimum.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - Sleeprider - 11-02-2022
What is the point of using a bilevel with no pressure support, and what does a full face mask have to do with the choice of EPAP? No offense, but the entire theory shows a complete lack of understanding of how the Vauto works. The Vauto does not use EPR, it uses pressure support which is added on to the EPAP pressure to achieve IPAP. The settings available are EPAP min, PS and IPAP or maximum pressure. If the difference between IPAP max and EPAP is greater than PS then you will have the Vauto algorithm available to automatically adjust pressure for obstructive breathing or events. You are correct that Ti and triggering would not affect therapy at these settings, but you will be getting flat CPAP with a pressure range of 7 to 20, and flow limitation will be in control of the pressure changes.
This is not for you, but I would be challenged to recommend that for anyone. If the purpose is titration for bilevel pressure, start at EPAP min 4.0, IPAP max 20.0 and PS 4.0. That is bilevel treatment. The PS will control flow limitations and dampen any pressure increases. If changes are needed, they will be very apparent in the first session and appropriate changes can be made. If you want to titrate CPAP treatment, then just forget the PS setting, but if your intent is to use bilevel, then use the PS and use the data to fine-tune. If you want to be conservative with PS, than change the PS to 2.0 or 3.0, but dont' turn it off unless there is a known problem with central apnea or periodic breathing. You will learn more about tolerance and efficacy of PS by using it, than eliminating it.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - KeepSmiling - 11-02-2022
Sleeprider,
Once again thanks for info.
The reason I was thinking of PS off, was to avoid issue like I had to adjusting to EPR.
I want to titrate someone else, instead of spending a lot of money for a titration.
Peron never been titrated waiting to see doctor for a sleep study. One at home study did not show much info except some desaturations.
Our thoughts if the machine picks up events that the machine responds to then the person needs a machine. If there are events they can be shown to doctor.
We suspect UARS. Person has seen family doctor for testing nothing can pinpoint weight gain, low blood pressure, sleepy all the time, dizziness upon standing. Lung test were negative. Family doctor recommended to check for Sleep Apnea. At home sleep study did not show obstructive apnea. We are trying to make a case for a sleep study.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - Sleeprider - 11-02-2022
Titration is a trial and error process that challenges the patient with pressure(s) and a technician with knowledge of the process observes the results and mnakes changes according to an established protocol. For CPAP, the pressure starts at 4.0 cm and pressure is increases by increments of 1-cm until obstructive events (OA, RERA Hypopnea) are reduced to an acceptable level. Pressures are then changed more slowly until a pressure is found that does not result in events and hopefully demonstrated a full range of sleep stages. Bilevel titration often follows CPAP titration when pressure exceeds 15 cm, and adds in pressure support which can improve tolerance and reduce events. For any machine in the Resmed series, this Sleep Lab Titration Guide gives a decision tree of how to titrate a patient https://document.resmed.com/en-us/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
For bilevel titrations, the protocol is on page 24. The titration starts at 8.0/4.0 and for obstructive apnea, the EPAP is raised in 1-cm increments while observing results, and for hypopnea (flow limitation/RERA) IPAP, or pressure support is increased. With the Vauto this process is automated, for EPAP, but PS needs to be manually increased.
You suspect UARS and that is always treated with PS. DO NOT use a flat CPAP to titrate this person. Start with the settings I suggested as supported by this titration protocol, then make observations of how to modify those settings. The only thing you will end up doing in this case is increasing the starting EPAP or changing the PS according to the protocol. A person with UARS will have the sleep of their lifetime with the assist of pressure support, and everything else will sort with a bit of observation and adjustment by someone that understands how people and their conditions respond to changes in pressure, pressure support and finally timing or sensitivity.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - KeepSmiling - 11-03-2022
Sleeprider,
Yes I have that manual. I was going to make it easy and do what DMEs do around here:
Set up CPAP Auto 4-20 cm fit a mask and off you go.
OK, I will start with EPAP 8 and PS 4.
Titration was not the right word to use. My goal is to show doctor that a CPAP machine of some type is needed, because the patient has events or flow limitations that the machine responds to. so the patient will benefit from a full sleep study and a machine.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - Sleeprider - 11-03-2022
That is not what I said. My recommendation is for Vauto mode with EPAP min 4.0, PS at your discretion, but given a suspician of UARS, 2.0 to 4.0 cm PS is appropriate, and PS 3 will replicate the Autoset EPR of 3. With a Vauto, PS is added to EPAP rather than subtracted from IPAP. If you can wrap your mind around that difference, than we will be on the same page.
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - DaveL - 11-04-2022
This is a wonderful thread and I've learned a lot!
Good question.
Sleeprider wonderful answers!
RE: Titration with a Resmed AirCurve 10 VAuto - would this work. - KeepSmiling - 11-04-2022
Sleeprider,
Thank you for catching my mistake.
Lucklly, it was put on hold, so I have more time.