Which Machine?

[Paul22]

I presently am using a Respironics Bipap Auto Series M set on 11/8 cm H2O (straight Bipap, no Auto).. My normal breathing pattern requires a longer TI than permitted by this machine. A Respironics tech told me that the TI is hardwired at 3sec, and my observations agree. I need a machine that has a longer TI, preferably 10 seconds, but I could get by on 6 sec (I also do some slow breathing exercises as part of a relaxation technique).

Some day I hope to find a full face mask that I can wear—right now am using a Nasal Aire II and have trouble with mouth breathing. If I am to use a full face mask, I will have to have a machine that transitions gradually from expiration to inspiration. The sudden transition in the few machines I have been exposed to feels like someone hitting a drum inside my face and keeps me from going to sleep.

The auto setting on my machine does not yield good results for me so I think that I want a straight Bipap but would buy a more exotic machine to get the longer TI and a more gradual rise time going from expiration to inspiration—if it could be set to operate straight Bipap. I also want a read out (Smart Card or?) so that I can see the results for each night.

I have searched the web as best I can and have not found the information I am looking for. Could someone of the knowledgeable persons please tell me which machines I should look at—or even if there is such a machine?

One last question. Where can I find a list of the abbreviations, and their meanings, used on this site?

Thank you.

Paul22

[Slinky]

Paul, I do not understand the Ti Minimum and Ti Maximum "options" on the Resmed S8 II VPAP Auto all that well. However, if you want to PM me w/your e-mail addy I can send yuo a pdf of the VPAP Auto's Clinician Manual. The Resmeds use a formula: Ti Max = (60 divided patient's respiratory rate) divided by 2. (For instance a RR of 30 calculates a recommended Ti Max of 1.0 seconds up to a RR of 10 for a Ti Max recommendation of 3.0 seconds. The limits I find on my VPAP Auto are 1.0 to 4.0.

The manual does state

... The TiContral feature is unique to Resmed bilevel devices. It allows the clinician to set minimum and maximum limits on the time the device spends in IPAP. The minimum and maximum time limtes are set at either side of the patient's ideal spontaneous inspiratory time, providing a 'window of opportunity' for the patient to spontaneously cycle to EPAP.
The minimum time limit is set via the Ti Min parameter and the maxium times limit is set via the Ti Max parameter.
TiControl's Ti Max and Ti Min parameters play a significant role in maximizing synchronization by effectively intervening to limit or prolong the inspiratory time when required. This ensures synchronization even in the presence of significant mouth and/or mask leak.
The majority of patients on bilevel therapy experience mouth leaks, especially during sleep. During mouth leak there may be poor synchronization between patient and machine breaths, which reduces both the comfort and effectiveness of therapy.
The VPAP Auto allows clinicians to specify a maximum IPAP time (i.e. the time the device spends delivering the inspiratory pressure during a spontaneous breath). Thus if a patient develops mouth leak, the VPAP Auto automatically cycles to EPAP after reaching the maximum time set by the clinician.

In Spontaneous Mode there is also a Rise Time Adjustment. Rise Time cannot exceed the Ti Max setting. I don't know if this is of any help at all or not or even if the Clinician's Manual would be of assistance to you. But maybe it would be worth your while to check on the possibilty of renting a VPAP Auto for a month to try. Maybe.