SETTINGS HELP

Hi,

Have been using BiPAP in S mode as originally prescribed. The settings I have been using:
IPAP 14.0
EPAP 10
Ti Max 2.0 sec
Ti Min 0.3 sec

I have been doing pretty well and sleeping much better since starting therapy.

I just got a new BiPap machine and looked at how they set it up. The settings above are the same, except they sent it in the VAuto mode and added a PS of 4.
I am interested in trying the VAuto mode and I would like to know if the settings are correct to start?

Appreciate your guidance.

Slumberseeker wrote: ↑

Thu Dec 05, 2024 2:06 pm

IPAP 14.0
EPAP 10

These settings effectively give you PS of 4.
PS is pressure support or the difference between inhale and exhale.
In S mode you won't see PS in the menu but it's there by default even if not specifically mentioned.

In VAuto mode is max IPAP set to 14? Or something higher?

If the new machine is set to VAuto mode with these same settings...EPAP 10 and IPAP 14 then it can't/won't do any auto adjusting or changing of the pressures. It may say VAuto mode but it effectively is still going to function like S mode.

If you want to try VAuto mode then you need max IPAP setting to be something the machine can go to.
And when it goes up then it drags EPAP up with it.
There would always be 4 cm difference between inhale and exhale.

Thank you Pugsy,

Would you suggest IPAP of 18 or 20? to start?

Slumberseeker wrote: ↑

Thu Dec 05, 2024 3:11 pm

Thank you Pugsy,

Would you suggest IPAP of 18 or 20? to start?

In VAuto mode the correct terminology is Maximum IPAP and not just IPAP....So understand what I am talking about.

If it were me and I wanted to try VAuto mode (bear in mind I have zero idea what kind of results you were getting with your S mode settings)
gotta start somewhere and something similar to what you were using except it could go up IF IT FELT THE NEED
I would go with
Minimum EPAP 10
PS 4
Maximum IPAP 20
and just see where things go.
I don't suggest messing with the other settings (like Ti min or max) a this time.
With these settings it is going to feel the same way it has always felt in the past until IF the machine wanted to go higher.
You start out with 10 EPAP and 14 IPAP.

You might do well with less EPAP but that would involve other experiments.

There is one major difference between S mode and VAuto mode that affects feel. It may not matter to some people (e.g., with low ventilatory demand), and it depends on what value you assign to that setting, but it makes such a huge difference to me that I can't use VAuto mode because of it. The difference is there and one needs to consider it. I am referring to "Rise time", which is simply not available in VAuto mode (or if the Easy-breathe setting is "on") and defaults to some rather high value. In S mode, it can be set from 150 to 900ms. I have a very high ventilatory demand and 150ms is barely enough for me, but for some people whatever the value is in VAuto mode may be good enough. Just pointing it out, in case it ends up making a difference to the OP.

McSleepy