How do I ncrease Dreamstation max pressure to 40?

[MountainGuy]

Been reading a lot about how these machines are capable of pressures up to 40cmH2O. If you end up getting stuck without a ventilator, this could really make a difference.

In step-by-step layman's terms, can anyone tell me how to change my Dreamstation's maximum pressure to 40 in the (hopefully) unlikely event that we'll ever need it?

[chunkyfrog]

Such a modification is beyond the design parameters of the HARDWARE.
If such a thing were possible, it might only work for a few minutes, if that.
Then . . . . Phhhhht!

[Goofproof]

Hook it in series with a Electrolux vent output (blow side), or real answer, you don't! Jim

[LSAT]

You should ask whoever wrote the article saying that it was possible

[zonker]

Been reading a lot about how these machines are capable of pressures up to 40cmH2O. If you end up getting stuck without a ventilator, this could really make a difference.

In step-by-step layman's terms, can anyone tell me how to change my Dreamstation's maximum pressure to 40 in the (hopefully) unlikely event that we'll ever need it?

welcome to the zoo!

please be more careful in your reading. there is a LOT of incorrect information out there. there is no way you are going to be able to use a cpap as a ventilator.

in the meantime, stay safe.

good luck!

[Wulfman...]

Been reading a lot about how these machines are capable of pressures up to 40cmH2O. If you end up getting stuck without a ventilator, this could really make a difference.

In step-by-step layman's terms, can anyone tell me how to change my Dreamstation's maximum pressure to 40 in the (hopefully) unlikely event that we'll ever need it?

They are NOT capable of that pressure under any normal situations.

From the manual of the Dreamstation ASV machine:

Parameter..........Range................Accuracy
IPAP.................4 – 30 cmH2O.......± 2.5 cmH2O*
EPAP................4 – 25 cmH2O.......± 2.5 cmH2O*
CPAP................4 – 20 cmH2O.......± 2.5 cmH2O*
Breath rate........4 to 30 BPM.........greater of ± 1 BPM or ±10% of setting
Inspiration time...0.5 to 3 seconds...± (10% of setting + 0.1 second)

Contraindications
When assessing the relative risks and benefits of using this equipment,
the clinician should understand that this device can deliver pressures
up to 25 cm H2O. In the event of certain fault conditions, a maximum
pressure of 40 cm H2O is possible.


From The Bi-PAP manual:

Pressure Accuracy
Bi-level Pressure Increments: 4.0 to 25.0 cm H2O (in 0.5 cm H2O increments)
Bi-level maximum static pressure accuracy, according to ISO 80601-2-70:2015:

Contraindications
When assessing the relative risks and benefits of using this equipment,
the clinician should understand that this device can deliver pressures
up to 25 cm H2O. In the event of certain fault conditions, a maximum
pressure of 40 cm H2O is possible.
.

In other words, you don't want them to have the "certain fault conditions".

Den

.

[arhdc]

Guys have been haking old CPAP units apart and hooking power directly to the blower motors are claiming that they are able to get pressures of 40cmH2O. I have not seen any of these projects that have used a Dreamstation but I do not doubt that the blower would be able to reach those pressures. We have no way to know how long it would last running wide open like that and to do so you are abandoning all of the advanced software and regulation that is what makes a CPAP different from a Shop-Vac. If Philips comes up with a software mod to hotrod Dreamstations or someone develops a replacement control board it may be possible to get something useful with these pressures, otherwise, just forget it.

On a side note, everything that I have read so far indicates that pressures of 14-18cmH2O are what are most useful for Covid-19 patients, super high pressures do more harm than good.

[D.H.]

If don't know where this came from.

I also don't know that any standard CPAP mask or hose would support this if you could achieve that.

Does that, by chance, have anything to do with claims that are going around (of whose validity I'm not confident) that CPAP machines could be modified to treat Covid-19 if no ventilator is available?

[palerider]

Been reading a lot about how these machines are capable of pressures up to 40cmH2O. If you end up getting stuck without a ventilator, this could really make a difference.

In step-by-step layman's terms, can anyone tell me how to change my Dreamstation's maximum pressure to 40 in the (hopefully) unlikely event that we'll ever need it?

You CAN'T

[palerider]

On a side note, everything that I have read so far indicates that pressures of 14-18cmH2O are what are most useful for Covid-19 patients,

What you've read is *NOT* anywhere near 'the whole story'. because while they may be using 14-18 PEEP, they're also using up to 25PS.

[Wulfman...]

If don't know where this came from.

I also don't know that any standard CPAP mask or hose would support this if you could achieve that.

Does that, by chance, have anything to do with claims that are going around (of whose validity I'm not confident) that CPAP machines could be modified to treat Covid-19 if no ventilator is available?

I've seen some references to the situations that in quite a few cases regarding the Covid-19, ordinary CPAPs or Bi-Level would be sufficient. But, I also don't know if some of those "talking heads" are confusing "flow generators" (XPAPS) with ventilators or if they want that many ventilators just to have them handy and/or use them for any situation.


Den

.

[arhdc]

On a side note, everything that I have read so far indicates that pressures of 14-18cmH2O are what are most useful for Covid-19 patients,

What you've read is *NOT* anywhere near 'the whole story'. because while they may be using 14-18 PEEP, they're also using up to 25PS.

Not to start a fight with you Palerider, you are my favorite part of this forum, but there are a number of publications related to Covid-19 that claim high pressures are not needed in most cases for NIV. Early attempts at non-invasive ventilation for Covid-19 did use higher pressures, 25-30cmH2O, based on experience with other pathologies. Most NIV therapy is done using BiLevel modes historically using higher pressures. Covid-19 is moderately unique in that it seems to affect the structure of the lung tissue weakening it without making the lungs non-compliant. Many patients feel that they are breathing just fine even when they are not adequately oxygenating. What this means is that high pressures are not required to dive air into the lungs BUT the air passages need to be pressure splinted open to compensate for the loss of structural integrity thus CPAP may be more effective than BiLevel. Too much pressure and the structurally compromised lung tissue actually becomes more damaged. This is not true in all cases so one can not claim that higher pressures are not needed, but many cases do not require high-pressure NIV.

My point in all of this is that it is better to have a device that works properly delivering pressures within its design parameters than to sacrifice all of that in the pursuit of high pressures.

[palerider]

On a side note, everything that I have read so far indicates that pressures of 14-18cmH2O are what are most useful for Covid-19 patients,

What you've read is *NOT* anywhere near 'the whole story'. because while they may be using 14-18 PEEP, they're also using up to 25PS.

Not to start a fight with you Palerider, .. . but many cases do not require high-pressure NIV.

Most cases don't require ventilation at all, NIV or IV.

As the doctor says, "if you have trouble breathing, go to the hospital, otherwise, stay home".

https://www.youtube.com/watch?v=YitWZj9QhdQ

[Goofproof]

Just go to Harbor Freight, buy a air compressor, regulator, and air hose. You could even air your tires with it, but most people would complain about the noise, if they still could. Jim

[chunkyfrog]

Some people are able to repair, and even modify equipment.
Others can only dream of what they "could" do, "if given a chance".
The most any of these people can do is void warranties and start fires.
"Oh, look at the pretty smoke."