BiPAP inhale versus back up breathing?
What would be the difference in experience between the Respironics BiPAP forcing an inhale and a machine with a back up rate?
My question comes from the experience of having the BiPAP make aggressive ventilation noises and shove air down my throat before I was ready for it. It would force an inhale before I inhaled.
While I was being titrated on BiPAP and still awake, I began to play with every breath so I could figure out what the machine was doing (since I wasn't aware of this feature in advance). I tried to make it slow down, but NO. I tried to see how off-kilter I could make it: unproductive. I tried to throw a big exhale at it. Nyet. A sigh. Mais non. No control on my part. I did this for the best part of 1 1/2 hours, since I was captive at the sleep center.
How is this different from having back up support? Which machines have back up support anyway? Back up support forces an inhale, correct?
RE: BiPAP inhale versus back up breathing?
The pressure support from bilevel without backup can greatly reduce the effort of inspiration, but it won't initiate a breath. The impression it would not slow down, or was somehow pacing your breathing rate is simply not the case. The pressure support may end before your are done with a particularly long breath, but the machine does not have the ability to switch to IPAP pressure before you are done exhaling. With a backup rate, ou wuld receive full IPAP pressure at a paced or timed rate regardless of whether you initiated the breath spontaneously or not. It takes some time to get used to the feeling of bilevel, but it really sums up as doing part of the work for you, or even all the work for you, but the trigger for IPAP and cycle to exhale is not timed, it just follows.
RE: BiPAP inhale versus back up breathing?
I’m going to have to think about this. There’s some detail I’m missing...
RE: BiPAP inhale versus back up breathing?
You may be feeling the BPAP sending a pressure probe which is a 1cm to 2cm burst that it sends out to check if there's an obstruction. If your holding your breath it thinks your having an event and it probes to see if it's an obstructive event or a clear airway event.
That would feel like it's forcing air but it wouldn't last long.
RE: BiPAP inhale versus back up breathing?
That’s an idea....I was in fact holding my breath to see if it would blast pressure before I breathed. It did. I had altogether too much time on my hands, as you can tell.... you’re thinking this might have been an exploratory blast... hmmm
There was no pulse, though. It was one aggressive blast. I eventually had to give in and go with it.
Is it possible, though, that Respironics has different types of BiPAPs, and I might indeed have been getting back up? The tech only told me I was getting BiPAP titration (she corrected me: not BPAP, definitely Respironics). She could have had me on different iterations of BiPAP?
Now this topic merged with my titration thread.....
12-22-2017, 09:08 PM
(This post was last modified: 12-22-2017, 09:10 PM by Sleeprider.)
RE: BiPAP inhale versus back up breathing?
Respironics has the BiPAP Auto SV Advanced which is an ASV, as well as the BiPAP ST which has backup and impressive pressure support. The BiPAP S is a fixed pressure, and BiPAP Auto is auto-pressure bilevel without backup. It my understanding that the machines used to test patients at most facilities are able to test all of the BiPAP modes from a single machine. Whether your technician had instructions to do so is the question.
That raises another point. The pressure pulse is used by all Philips Respironics machines to differentiate the type of apnea (open airway or obstructive), but I don't know if the titration testing machines do that because the lab usually has a chest strap and other sensors that can determine the type of apnea.
RE: BiPAP inhale versus back up breathing?
I didn't realize it was in a sleep center. I agree about no pressure pulse with a lab machine.
RE: BiPAP inhale versus back up breathing?
I’ll bet that explains why the pressure seemed timed. I had requested BPAP and ASV split study titration, and they may have obliged me by using a Respironics BiPAP variation so they could try different modes. I did not get a CPAP/BiPAP titration as they had originally ordered. The tech was very clear this was BiPAP only; she may well have not wanted to confuse me with more detail.
I guess I’ll know when I get the results.
RE: BiPAP inhale versus back up breathing?
On my untimed bilevels, I can hold my breath as long as I can and they certainly don't kick to IPAP, and since the sensation was of overwhelming pressure, that certainly doesn't sound like conventional bilevel, but a machine with perhaps adaptive pressure support?
RE: BiPAP inhale versus back up breathing?
It sounded like a ventilator, to tell you the truth. It was one noisy son of a gun. Clunk. Clunk. The experience wasn’t like my APAP at all, where I breathe however I want and more or less end up breathing in a rhythm. The pressure at 12cm was way more aggressive than the A10A, too. There was no way I could avoid taking a breath.
I guess I’ll find out soon.
