New Resmed VPAP COPD questions

[Heidi]

Can anyone explain the difference between Trilogy 100 and Resmed VPAP COPD?

Does the Resmed VPAP COPD come ready to use and no settings needed? Gosh that would be helpful because they are having a hard time figuring out settings on my Trilogy 100.

Thanks!

[palerider]

Can anyone explain the difference between Trilogy 100 and Resmed VPAP COPD?

Does the Resmed VPAP COPD come ready to use and no settings needed? Gosh that would be helpful because they are having a hard time figuring out settings on my Trilogy 100.

I'm afraid I don't know enough about the Trilogy to explain the differences between it and a VPAP COPD, I do know this:
a resmed VPAP COPD is a VPAP S with presets that are a good starting point for COPD patients, from the manual:

The VPAP COPD is designed for the treatment of patients with COPD, and therefore, the values of the key
parameters are already preset. This allows you to start treatment quickly with typical settings for this
group of patients.

Code: Select all

The key parameters and their settings are as follows:
Parameter            Default setting
IPA                  13 cm H 2 O
EPAP                 5 cm H 2 O
Rise Time            150 ms
Fall Time            100 ms (not adjustable)
Trigger sensitivity  Medium
Cycle sensitivity    High
Ti Min               0.3 sec
Ti Max               1.0 sec

So, no need to buy a VPAP COPD, any VPAP S, ST, or Auto can be programmed that way in a couple of minutes.

my initial feeling is that you'd be better off with the VPAP ST-A machine (iVAPS). from the titration guide:

Which patients is iVAPS suitable for?
iVAPS is suitable for adults with respiratory insufficiency. It is ideal for patients whose condition is likely to change and
is characterized by hypoventilation (day/night hypercapnia).
Patient conditions may include:
• Neuromuscular disease and restrictive conditions — iVAPS can maintain stable ventilation when respiratory effort fluctuates
• Obesity hypoventilation — When compared to standard Pressure Support therapy, iVAPS can compensate for changes
in respiratory mechanics, such as during nocturnal changes in the patient’s body position iBR stays out of the way when not required
• Chronic obstructive pulmonary disease — iVAPS may reduce the risk of hyperinflation associated with increased respiratory rate, as compared to therapy targeting tidal volume
What does iVAPS target?
iVAPS targets alveolar ventilation to deliver required ventilation at the alveoli, where gas exchange occurs. Unlike other volume-assurance modes, iVAPS maintains the alveolar target even when respiratory rate changes.
Why is alveolar ventilation important?
Setting alveolar ventilation targets the patient’s true ventilation requirements and represents a more accurate approach.
It’s able to deliver the required ventilation at the alveoli, where gas exchange occurs, by taking into account and compensating for the portion of air that travels through the conducting airways.
What are the goals of therapy with iVAPS?
• Optimizing therapy by delivering a set alveolar ventilation with the right pressure at the right time
• Enhancing patient-ventilator synchrony with an intelligent Backup Rate (iBR) to enhance patient comfort
• Minimizing sleep disruption with its rapid, yet gentle response that is quick enough to maintain stable alveolar ventilation, yet smooth enough to maintain sleep quality during nocturnal therapy
• Increased adherence to therapy with iVAPS

If you'd like to read more: http://www.resmed.com/us/dam/documents/ ... lo_eng.pdf and discuss it with your doctor, many times their knowledge of current technology is lagging woefully behind the times.

[Heidi]

Palerider, so glad you answered! Wow this is some great information, this new machine sounds good to me. So no more tidal volume to worry about using this VPAP ST-A machine?

Is the iVAPS all preset? Would an RT have to do anything?

I'm new to all this thanks again.

[palerider]

Palerider, so glad you answered! Wow this is some great information, this new machine sounds good to me. So no more tidal volume to worry about using this VPAP ST-A machine?

Is the iVAPS all preset? Would an RT have to do anything?

I'm new to all this thanks again.

No, the iVAPS machine is possibly the most complicated of all to set up. I'd hesitate to wing it, though the majority of the instructions to create suggested prescription are in the titration guide.

it's one of those machines that needs to know how tall you are, and such.

here's a couple videos about it:
https://www.youtube.com/watch?v=nKniYnjMp9c
https://www.youtube.com/watch?v=O54vPGx2dKs

here's what looks to be a writeup about it, but it http://www.resmed.com/us/en/consumer/pr ... htmlwasn't coming up in my browser...possibly just an internet hiccough: