COPD and Titrations

I have COPD as most of you already know. In March of 2008 I had a bi-level titration and was started at IPAP 13, EPAP 8.

In October of 2008 I was put on Levaquin for 10 days for the COPD. 3 days after starting the Levaquin I had another bi-level titration resulting in a pressure change to IPAP 10, EPAP 5.
The "kicker" w/this October titration was the addition of a chin strap part way thru the night AND I've been unable to get the graphs as yet altho I've not given up trying yet.

Both titrations gave you a 5 cm gap between ipap and epap. To my way of thinking, that would be the most important number for you as a COPD patient.

I would probably run the VPAP Auto in VAuto mode (which is auto-bilevel mode) and set Max IPAP at 13 and set Min EPAP as low as you can stand it, anything between 4 and 8. You could always raise the min EPAP if you were having too many apneas. I would leave Ti Min and Ti Max alone, but all the other settings (Exhalation, Trigger, and Cycle) are comfort/synchronization settings, so I would feel free to try different settings of them to see what makes your treatment feel most comfortable. "Trigger" adjusts the sensitivity for how the machine senses when you breathe in, and Cycle adjusts the sensitivity for how the machine senses when you breathe out. Exhalation adjusts how quickly the pressure drops when you breathe out.

Of course, I am not a doc or RT, and you well know how new I am here, so I know you will take those factors into consideration with my words above. But those are my thoughts on what I would do, if that helps at all.

I'm beginning to get the hang of posting these images!



The October titration was posted at: "Second Bi-Level Titration & Tech Notes"

Thanks, jnk. Actually, since they both wanted me in Spontaneous mode and I kept encountering that "puff" at the end of inhalation, start of exhalation, I opted to put the ole VPAP back in auto mode and set the IPAP 13, the EPAP 5 and since both sleep labs had set the Pressure Support at 4 (I assume just the Default setting 'cause I didn't see Pressure Support on the scripts at all) I left Pressure Support at 4. I'm feeling good, my data is looking good, I've been content to stay right here - except it bugs me about the "puff" in Spontaneous mode. Especially since none of the "pros" have the answer or any idea for that matter.

I've been experimenting w/the Swift LT and the OptiLife cradle cushion masks. But I'm back to my faithful ole Simplicity and ready to start experimenting in Sponatneous mode again for a week in a day or two.