List of BIPAP machines with Backup rate?

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cnaumann
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List of BIPAP machines with Backup rate?

Post by cnaumann » Tue Oct 28, 2014 11:03 am

I know this sounds like like something I should be just be able to put into Google, but I am struggling a bit.
My prescription as written states:

BPAP-SET PRESSURE AT 16/9 WITH BUR 8/MINUTE
Heated Humidifier, compliance card and supplies ICD 327.29, 327.23 LON 99 months

I have a prescriptions code of CPT E0471 for the machine.

I know what most of this means, basically I need a bi-level machine to treat CSA. But I am having some difficulty finding a list of current machines from major maufactures that do this. On the CPAP.com website, I don't see anything about having a back up rate as a selection criteria.

On the ResMed site, I see CPAP machine, VPAP, and non-invasive ventilation. Am I looking at something like the S9 VPAP ST under non-invasive ventilation?

I would like to have an idea of what machines are available, compatability with sleepyhead, avaialability of the clinitions manual, etc. before I talk to my DME provider, but I am having a little trouble coming up with a list.

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Re: List of BIPAP machines with Backup rate?

Post by Pugsy » Tue Oct 28, 2014 11:18 am

You can request pretty much any clinician manual from this site
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Right now software is easily obtained for either the ResMed or the Respironics machines...Sleepyhead works with both and we can point you to where you can get ResScan (ResMed) and Encore (Respironics) brand name software if you wish.

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Re: List of BIPAP machines with Backup rate?

Post by Krelvin » Tue Oct 28, 2014 11:32 am

Think they are looking for what machines match the requirements rather than where to get a manual for them ie.. needs to get a machine, but doesn't know which ones match the RX.
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Re: List of BIPAP machines with Backup rate?

Post by Pugsy » Tue Oct 28, 2014 11:44 am

Krelvin wrote:Think they are looking for what machines match the requirements rather than what software you can use with them. ie.. needs to get a machine, but doesn't know which ones match the RX.
Just confirming that software is available no matter which one they get.
So I was answering this part of the question.
cnaumann wrote:I would like to have an idea of what machines are available, compatability with sleepyhead, avaialability of the clinitions manual, etc
If one gets the clinical manuals for the machine models in question then it would be relatively easy to determine which ones offered a back up rate.
I don't know enough about back up rates to be more specific.
My first thought would be to look at the PR System One 960 machine...I think it does everything
https://www.cpap.com/productpage/pr-60- ... anced.html
and also would be helpful to know if we are dealing with pure central apnea or complex apnea with OSA involved....as in do we need something that will auto adjust to kill the OAs or if pure centrals then a fixed pressure with back up rate would do the trick for just central apnea...in that case the S9 VPAP ST would probably work.

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Re: List of BIPAP machines with Backup rate?

Post by palerider » Tue Oct 28, 2014 12:29 pm

cnaumann wrote:I know this sounds like like something I should be just be able to put into Google, but I am struggling a bit.
My prescription as written states:

BPAP-SET PRESSURE AT 16/9 WITH BUR 8/MINUTE
Heated Humidifier, compliance card and supplies ICD 327.29, 327.23 LON 99 months

I have a prescriptions code of CPT E0471 for the machine.

I know what most of this means, basically I need a bi-level machine to treat CSA. But I am having some difficulty finding a list of current machines from major maufactures that do this. On the CPAP.com website, I don't see anything about having a back up rate as a selection criteria.

On the ResMed site, I see CPAP machine, VPAP, and non-invasive ventilation. Am I looking at something like the S9 VPAP ST under non-invasive ventilation?
prs1 960, s9 vpap st, vpap st-a are three that I know off offhand, the s9 vpap adapt doesn't have a settable backup rate, but it does do automatic backup. (the whole adaptable servo ventilation thing)

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Re: List of BIPAP machines with Backup rate?

Post by cnaumann » Tue Oct 28, 2014 2:03 pm

Thanks for the responses; I think most of my questions have been answered.

At my first sleep study, it was determined that I was having a combination of OSA, CSA and complex apnea events. At my second sleep study (first titration) it was determined that at moderate CPAP pressures (15cm) almost all the OSA events went away and all the complex events became pure central events. The Central Apnea index at 15cm of pressure was 30 with the average event lasting 32 seconds and the longest being 2 minutes and 16 seconds. They stopped at that point. It is not clear if the machine they were using could not do a backup rate or if they had to have permission to set it up.

I went back for a second titration study and they used a dual pressure machine that had a back up rate. (I think it was a REM Star 60 series machine but it was white. I meant to take a picture.) For most of the night, it felt like I was fighting the machine. The pressure would abruptly increase as I was exhaling, or would abruptly drop as I was inhaling. I complained, and the technician adjusted the backup rate and it was better but not ideal. I the abrupt pressure changes kept waking me up. The machine also seemed to want to me to breathe much faster and shallower than I normally do. I am tall and I have huge lungs. At rest, I just don't breathe very fast. During the first titration study, the technician told me a couple of times to 'breath normally--don't take such large breaths'. To which I replied through the full face mask at 15cm "NII AA NAAMMA". In the last few hours of the test I did fall asleep soundly and slept well with very few events (according to my own pulse oximeter, my official report for last night is not complete.)

Obviously, I want to get a machine that will allow me sleep well and stop damage to my body. I have a feeling that there is going to be a lot of fiddling to get the pressures and the backup rates optimal, even after the second titration study. I am intrigued by some of the machines that claim to be self-adjusting, but I have no idea if that is something that would be a help to me, and I am not exactly sure who is qualified to set such a machine up. I assume part of this is the role of the DME? I would really like to talk to a factory rep. To use a car analogy, my doctor’s prescription says something like "a am prescribing a car with 4 wheels, antilock brakes and airbags" and then I go to the dealer’s websites and they are talking about "advanced collision avoidance and traction control". All that sounds nice, but do I need that and how will I know if it works...

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Re: List of ASV BIPAP machines with Backup rate?

Post by JDS74 » Tue Oct 28, 2014 2:25 pm

The Respironics auto BiPap ASV 960 machine will do everything that you describe.
If the backup rate is set to auto, the machine will adapt to your breathing rate.
It will also switch to ventilator mode if you stop breathing for more than a few seconds and breathe for you.
The prescription values you provide are in the form usually or a ResMed machine and not a Respironics one.

Just a little fiddling after you have the clinician manual and it should settle down just fine.

For future posts, it will attract users that share your particular apnea problems if you include ASV in the subject line.
Note I changed the subject line to show this.

There are other machines that have a backup rate but are not ASV machines but I wouldn't go that route.

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Re: List of BIPAP machines with Backup rate?

Post by Pugsy » Tue Oct 28, 2014 3:37 pm

From what you describe I also think the PR System One 960 would probably suit your needs well.
It has more settings available and it allows for more customization of the breathing in terms of inhale and exhale response time. Might take a little more fine tuning of the settings initially but in the long run the potential for greater comfort is there. The S9 Adapt isn't quite so forgiving and while some people do well with it ....it can be more "demanding" that you adjust to its way of doing things instead of the other way around.
The 960 will offer more customizable respiration settings which ultimately might suit your respiration needs the best.

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Re: List of BIPAP machines with Backup rate?

Post by cnaumann » Tue Oct 28, 2014 5:39 pm

Thanks so much for the info.

I found a competitor's website that allowed me to search for machines by insurance code, the only two matches were the Resmed S9 ASV Adapt and the PR System One 960. I will take a crack at the clinical manuals tonight, but based on feedback the PR System One 960 is currently my first choice.

Now to find out if the 80% in network coverage is better than the 50% out of network coverage and if my insurance will cover DME purchased over the internet.

Fun times.

Shane, RRT

Re: List of BIPAP machines with Backup rate?

Post by Shane, RRT » Wed Oct 29, 2014 12:22 pm

A lot of people get confused about bilevel so I hope this helps:

VPAP or BPAP (variable/bilevel positive airway pressure) provides two levels of pressure: inspiratory positive airway pressure (IPAP) and a lower expiratory positive airway pressure (EPAP) for easier exhalation.

BIPAP Describes a mode of ventilation that alternates PEEP levels. The term, as used by Dragear on their ventilators, is "BIPAP" (upper case I).

BiPAP is simply a proprietary name for BiLevel and it's owned by Phillips Respironics (lower case i).

Respironics' current machine for bilevel with a backup rate is the BiPAP S/T. The model # is DS1060S

RedMed's current machine for bilevel with a backup rate us the S9 VPAP ST. The model # is 36018.

I hope that's helpful informations.

Cheers!

Shane, RRT

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Re: List of BIPAP machines with Backup rate?

Post by palerider » Wed Oct 29, 2014 12:58 pm

Shane, RRT wrote: RedMed's current machine for bilevel with a backup rate us the S9 VPAP ST. The model # is 36018.
Shane, RRT
the model number for the old vpap st is 36008, the model number for the current vpap st is 36038.

36018 is marketing code number for a old vpap st with humidifier.

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Re: List of BIPAP machines with Backup rate?

Post by cnaumann » Wed Oct 29, 2014 1:05 pm

Shane-

Thank you for replying.

I cannot find any current references to the PR BiPAP S/T #DS1060S on PR's website. I have found the machine in a few online dealers, often without a listed price.

I do not fully understand the differences bewtween the PR System One ASV 960 and the PR BiPAP S/T #DS1060S, and I cannot make a judgement as to would be a better machine for me. I am assuming from the descriptions that the ASV is somewhat more automated.

It looks to me that the PR System One ASV 960 is a newer model and may have even replaced the PR BiPAP S/T. But I really have no idea.

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Re: List of BIPAP machines with Backup rate?

Post by palerider » Wed Oct 29, 2014 1:10 pm

cnaumann wrote:Shane-

Thank you for replying.

I cannot find any current references to the PR BiPAP S/T #DS1060S on PR's website. I have found the machine in a few online dealers, often without a listed price.

I do not fully understand the differences bewtween the PR System One ASV 960 and the PR BiPAP S/T #DS1060S, and I cannot make a judgement as to would be a better machine for me. I am assuming from the descriptions that the ASV is somewhat more automated.

It looks to me that the PR System One ASV 960 is a newer model and may have even replaced the PR BiPAP S/T. But I really have no idea.
the function of a ST and an ASV are rather different, and are not good substitutions for each other, the 960 did NOT replace the 1060. in botanical terms, that'd be like replacing an apple with an orange.

if you've got compSA, it's most likely that your doctor wants you on an ASV, either the 960,or the vpap adapt, they're the machines that have been programmed to handle compSA and CSR.

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Re: List of BIPAP machines with Backup rate?

Post by cnaumann » Wed Oct 29, 2014 1:24 pm

I keep hearing and reading that they are 'different'. I understand that the ASV does some things that the ST does not do.
What I cannot figure out is what the ST is supposed to do that the ASV does NOT do.

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Re: List of BIPAP machines with Backup rate?

Post by ShaneRRT » Wed Oct 29, 2014 1:32 pm

palerider:

I'm not sure where your information is coming from, but the 36018 is not an "old VPAP". That is indeed the part # for the current VPAP ST (36008) + Hi5 humidifier. We almost always recommend using a humidifier with a CPAP or BPAP. This is a current model, I put patients on them all the time.

From ResMed's site http://www.resmed.com/us/en/commercial- ... ap-st.html

There is a 36039 (not 36038) which is the S9 VPAP ST-A and it's part with the Hi5 humidifier is 36049.
http://www.resmed.com/us/en/commercial- ... ivaps.html

cnaumann:

For some reason, Respironics doesn't put their part numbers on the website. You can find info about the BiPAP S/T at http://www.healthcare.philips.com/main/ ... e/bipapst/

Repironics also makes the 960 ASV also known as BiPAP autoSV advanced which is great for Complex Sleep Apnea. Info can be found at http://www.healthcare.philips.com/main/ ... efault.wpd

Shane
Registered Respiratory Therapist
Last edited by ShaneRRT on Wed Oct 29, 2014 1:42 pm, edited 1 time in total.