[Equipment] Expiratory pressure setting for AirSense 10 Autoset

[bazder]

Expiratory Pressure Relief setting for ResMed AirSense 10 Autoset manual says "When EPR is enabled, the delivered pressure will not drop below a minimum pressure of 4 cm H 2 O, regardless of the settings." so what I don't understand is the EPR levels of 1, 2, or 3 cm H2O? If my regular pressure range is 5 to 12 what will be the effect of changing the EPR to 1, 2 or 3 ?

I'm asking because the sales guy set it to 3 and I think the sample unit I tested on was set to 1. The new machine seems like it's pushing the air back in my lungs when I breathe out but the test machine was much more relaxed.

any help?

thanks


------------------------manual says-------------------------
EPR
On—EPR is enabled.
Off—EPR is disabled.
The following settings are only available if EPR is On:
EPR Type Full Time—If set to Full Time, EPR is enabled for the whole therapy session.
EPR Level 1, 2, 3 cm H 2 O
Ramp Only—If set to Ramp Only, EPR is only enabled during ramp time.
When EPR is enabled, the delivered pressure will not drop below a minimum pressure of 4 cm H 2 O,
regardless of the settings.

[zonk]

so what I don't understand is the EPR levels of 1, 2, or 3 cm H2O? If my regular pressure range is 5 to 12 what will be the effect of changing the EPR to 1, 2 or 3 ?

At low pressure, some would feel not getting enough air and the fresh air entering the mask is not sufficient to flush out exhaled air and can result in re-breathing own exhaled air

Whether EPR 1, 2, or 3 , exhale pressure does not drop below 4
With auto range 5-12 ... EPR level changes as pressure fluctuate
e.g ... EPR level 2, when pressure at 5, exhale pressure 4 (drop by 1) but as pressure increase to 6, exhale pressure 4 (drop by 2), again as pressure increase further, EPR level becomes the difference between inhale pressure and exhale pressure which is always 2

Personally, I don't use EPR, find it annoying but for some is a godsend
You can change it to whatever level feel most comfortable to you

[bazder]

thanks for the answer ... strangely enough the pressure seemed less last night so I'll leave it alone for a while - I think I'm still getting used to the whole thing.

[Possum]

At low pressure, some would feel not getting enough air and the fresh air entering the mask is not sufficient to flush out exhaled air and can result in re-breathing own exhaled air

Whether EPR 1, 2, or 3 , exhale pressure does not drop below 4
With auto range 5-12 ... EPR level changes as pressure fluctuate
e.g ... EPR level 2, when pressure at 5, exhale pressure 4 (drop by 1) but as pressure increase to 6, exhale pressure 4 (drop by 2), again as pressure increase further, EPR level becomes the difference between inhale pressure and exhale pressure which is always 2

Personally, I don't use EPR, find it annoying but for some is a godsend
You can change it to whatever level feel most comfortable to you

Zonk,

I've always wondered why many people seem to be against using the EPR setting, since I always thought it could only make therapy more comfortable by making it easier to exhale. Are you saying that if you don't use it, you can maintain fresher air (more oxygen-rich and CO2-poor) in the mask, by forcing exhaled air to be pushed out of the exhale ports due to the higher pressure at exhale? If so, that might be the answer to my lingering issue with blood oxygen desaturation events..

Thanks,
Possum

[Sleeprider]

EPR is kind of like using a bilevel machine with a pressure support of 3, except that instead of setting the EPAP minimum pressure, you begin with the CPAP minimum pressure, and EPR is subtracted from that.

With bilevel an EPAPmin is specified that is high enough to prevent airway collapse. Pressure support is added to obtain the IPAP pressure which should resolve hypopnea and RERA. For Auto Bilevel, the machine can increase EPAP and IPAP as needed above the minimum. CPAP with EPR is based on the CPAP pressure settings, but exhale relief is subtracted from that pressure. It is easy to imagine many people having EPAP pressure that allows airway collapse leading to increased OA.

For any CPAP the minimum pressure is 4.0, so EPR does not take effect until pressure is higher than 4.0. As a result, with low pressure settings up to 7.0, the possible IPAP/EPAP pressures are: 4/4, 5/4, 6/4, 7/4, 8/5 etc. Think in terms of bilevel therapy; someone who needs a minimum EPAP pressure of 8.0 needs to set the CPAP min pressure to 11.0.

EPR is great, but I think a lot of people miss how much it potentially reduces therapy pressures, and can allow OA to occur following expiration, before inspiration begins.

[trish6hundred]

Hi bazder,
WELCOME! to the forum.!
Much success to you with your CPAP therapy.