Suitable BiPaP machine for COPD patient with elevated Co2

Hi,
My father has been suffering from COPD and Left Ventricle Dysfunction for the past five years. He also has obstructive sleep apnea and has been on AutoCPAP for the past four years. Last week his CO2 level (65 mm Hg) was elevated and was hospitalized. Doctors have suggested Auto BiPaP with ST for home use. I have two options for AutoBiPap. One from Philips Respitronics AutoBiPaP AVAPS and the other is from Resmed S9 VPAP ST with iVAPS. The philips model is priced higher (about 10 -15%) than the Resmed model. Can anyone suggest which one of the above would be better for COPD patient with hypercapnia and LVD? Meanwhile the Bipap sales person is trying to convince me to by a SV model (Servo Ventillator) which is way to costly.

Regards
Saravana

The ResMed S9 VPAP COPD is a great machine for people not requiring a backup rate (I feel this is more appropriate than the S9 VPAP ST). You will first want to see if your prescription currently requires a backup rate or if your doctor if they feels that a backup rate may be required in the future. If the option of a backup rate is desired the S9 VPAP ST-A would be the best machine in my opinion. Hopefully you have the relationship with the doctor to talk about and select a machine with their advice. The equipment provider may have selfish motives for recommending machines.

Hi Mark,
Thanks for your comments. My doctor has advised a machine with backup rate. As per your suggestion can I go ahead and buy Resmed S9 VPAP-ST with iVAPS. The supplier is suggesting S9 VPAP-ST iVAPS instead of S9 VPAP-ST-A with iVAPS. He says the only difference between the two is the alarm module in VPAP-ST-A which he says will not be required for home use. Kindly suggest

The VPAP ST and ST-A have several differences. While they each have the same modes the differences are in the ranges of therapy and the alarms. I personally would find the alarms quite handy on the ST-A model. Let's look at some of the specs on each.

S9 VPAP ST-A
Pressure range
IPAP: 2–30 cm H2O EPAP: 2–30 cm H2O CPAP: 4–20 cm H2O
Alarms
High leak
Non-vented mask
Low minute ventilation
Apnea
Low SpO2 (when oximeter attached)

S9 VPAP ST
Pressure range
IPAP: 4–25 cm H2O EPAP: 2–25 cm H2O CPAP: 2–30 cm H2O

In my opinion having the ability to set IPAP at starting number as low as 2 could assist with compliance in a difficult patient. Having the upper limit of 30 instead of 25 for this number could make the machine usable for a longer period as the needs increase. The alarms can be vital for not only the patient but also care givers in the home, but that is a minimal part of the difference. I would get multiple quotes on the machine. It is possible to find either for less than $4k US. Make sure that your equipment provider is not trying to sell you the ST because that is what they have on the shelf and can't find a patient for. Any provider can have the ST-A sent to them the next business day.

These are my opinions, you should have a doctor involved in the final decision and not an equipment provider or some random guy like myself on the Internet.

Hi Marks,

Thanks for your suggestion and feedback