AutoPAP and BiPAP combined

WillSucceed · Post by **WillSucceed** » Tue Jan 25, 2005 11:46 am

Do any of you know of a machine that has autopap features (adjusts pressure as needed in response to flow limitations, etc.,) AND also has the ability to deliver a back-up rate for those people who have central apneas and need the machine to kick-in with a rate when a central occurs?

snoozin' · Post by **snoozin'** » Tue Jan 25, 2005 1:52 pm

Are you looking for something like the RemStar Auto w/C-Flex? It's an autopap with the ability to have a lower exhale pressure. If this sounds like what you're looking for, check the CPAP Interviews for more information.
viewArticle/Respironics-Remstar-Auto-Pr ... rview.html
Debbie

rested gal · Post by **rested gal** » Tue Jan 25, 2005 2:27 pm

WillSucceed, the kind of dream machine combo "autopap/bipap with timed feature" you're talking about might very well be the new ResMed CS 2 that ResMed has developed to deal with Cheyne-Stokes breathing in congestive heart failure patients. However, that new machine's timed kick-in feature might very well also be beneficial for predominately central apnea patients while still providing the varying pressures of an "autopap".

I don't know about Canada, but the ResMed CS 2 is not available in the U.S. yet. I believe it's currently undergoing clinical trials for U.S. FDA approval.

ResMed Autoset CS2 brochure

WillSucceed, although you are talking about central apnea, not Cheyne-Stokes breathing, a topic about the C-S breathing pattern is at:

Dec 30, 2004 Subject: Cheyne Stokes Respiration

eszrthsetrh · Post by **eszrthsetrh** » Wed Sep 17, 2008 2:58 am

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THier · Post by **THier** » Wed Sep 17, 2008 3:47 am

Is this what you are looking for?

https://www.cpap.com/cpap-machine/Respi ... -Gray.html

Tom

dsm oseas · Post by **dsm oseas** » Wed Sep 17, 2008 8:08 pm

THier wrote:Is this what you are looking for?

https://www.cpap.com/cpap-machine/Respi ... -Gray.html

Tom

You may not have noticed but you responded to a spammer that activated a 2 year old thread.

In reply to your post, the Bipap S/T isn't an Auto. It does though have a timed rate. The more likely candidate (but still not exactly what WillSucceed asked for) is the Bipap Auto SV - it comes pretty close but whilst it auto adjusts ipap pressure as needed on a breath-by-breath, it doesn't adjust epap which remains manually set. It is what is called a Servo Ventilation mode machine.

There are two good AUTO BiLevels (the Respironics Bipap Auto & the Resmed Vpap Auto) but neither of these have a timed rate.

I would think the Bipap Auto SV is a better solution than even WillSucceed imagined way back then.

Cheers

DSM

THier · Post by **THier** » Thu Sep 18, 2008 3:48 am

dsm oseas wrote:
THier wrote:Is this what you are looking for?

https://www.cpap.com/cpap-machine/Respi ... -Gray.html

Tom
You may not have noticed but you responded to a spammer that activated a 2 year old thread.

In reply to your post, the Bipap S/T isn't an Auto. It does though have a timed rate. The more likely candidate (but still not exactly what WillSucceed asked for) is the Bipap Auto SV - it comes pretty close but whilst it auto adjusts ipap pressure as needed on a breath-by-breath, it doesn't adjust epap which remains manually set. It is what is called a Servo Ventilation mode machine.

There are two good AUTO BiLevels (the Respironics Bipap Auto & the Resmed Vpap Auto) but neither of these have a timed rate.

I would think the Bipap Auto SV is a better solution than even WillSucceed imagined way back then.

Cheers

DSM

DOH,,, didn't notice,,, sorry,,, thanx,,, and I was thinking of the SV,,, oppss struck out, fumbled,, fouled out,,, errored,,, never mind,, back to my corner.

jnk · Post by **jnk** » Thu Sep 18, 2008 7:43 am

dsm oseas wrote:. . . Resmed Vpap Auto . . . neither of these have a timed rate.

dsm,

Thanks for keeping an eye on us from overseas.

I figure no one will mind me hijacking a spammed up rethread! So here's my question:

I know that the VPAP Auto does not have a mechanism for switching over to a purely timed rate. But since it does have TiControl adjustments, like the VPAP III ST, couldn't it, in practice, be set so that the window of opportunity was specifically limited enough to ensure a particular rate?

I am just trying to wrap my mind around this stuff, so any help is appreciated:

http://www.resmed.com/en-us/products/fl ... =products2

-SWS · Post by **-SWS** » Thu Sep 18, 2008 8:29 am

Jeff, the Ti controls are only inspiratory time-duration limits. Ti min deals with the minimum time the machine will spend in IPAP once that same IPAP has been spontaneously triggered by the patient. Ti max deals with the maximum time the machine will be allowed to spend in IPAP once that same IPAP has been spontaneously triggered by the patient.

In both cases the machine's inspiratory cycle (IPAP) waits until the patient has spontaneously commenced that cycle. You can thus influence respiratory rate with Ti controls (intentionally or inadvertently) but you can never back up missed breaths (central apneas) with Ti controls. Hope this helps.

P.S. A whopping Ti max value of 4 seconds means that the machine will simply allow for (not regulate) a respiratory rate to be as slow as 7.5 breaths per minute, give or take significant BPM variability for an individualized IPAP/EPAP ratio (note: that 7.5 BPM practical estimate merely assumes a somewhat uncommon 50/50 ratio). But Ti controls regulate switch over from IPAP to EPAP----not the centrally crucial EPAP-to-IPAP machine transition that would be tantamount to providing a traditional inspiratory-based backup rate. In summary: central apnea backup rates work on the EPAP-to-IPAP transition. Ti controls work on the IPAP-to-EPAP transition (the latter can thus influence respiratory rate while being incapable of backing up either latent or missed inspiration).

jnk · Post by **jnk** » Thu Sep 18, 2008 9:42 am

SWS,

Wow! That helps immensely! That helps several concepts fall into place for me on a number of levels. Perfect explanation, and at my level of English comprehension too, so I really do appreciate it.

I've had trouble, mentally and physically, with those Ti controls from day one. The first machine delivered to me was a VPAP III that the DME people had left on what I guess is the default of two seconds for Ti max. With my allergies, that wasn't enough time; it kept triggering epap before I could get a full breath. It drove me crazy! What a nightmare for a first night! So in the middle of the night I fired up the computer and found the information I needed in this forum for how to get into the menu to be able to change that adjustment to three seconds. Then I slept like a baby. So I guess I should thank my DME for their part in helping me to find and appreciate this forum, eh?

Anyway, I think I get it now. Thanks again.

jeff

AutoPAP and BiPAP combined

AutoPAP and BiPAP combined

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