MyEncore for Encore Pro 1.5 - New Auto BiLevel Users

[derek]

I now have MyEncore working for Encore Pro 1.5 !!! There are a couple of things to do before I start to release it:

1) I need a copy of the Encore Pro Ver. 1.5 database of a user of the new Auto Bilevel with BiFlex so that I can integrate the new machine into MyEncore. Would anybody who could provide me with a copy please PM me and I will give you instructions.

2) I am struggling with what to do about the new password provision when you install Ver 1.5. Microsoft strongly recommends that you don't use the SA account for accessing the SQL server, instead they urge using the integrated security system, but that limits access to MyEncore only to users with Windows 2000 or XP. In the previous MyEncore I reverted to using the SA account because there were several Windows 98 users who were locked out of MyEncore because of this.
So my choices are - require that you install Encore Pro 1.5 with no password (which was the case for Encore Pro Ver. 1.4), or require users to specify to MyEncore the password you entered when you installed Encore Pro 1.5. There are some security issues here...
If anybody has any thoughts, please let me know.

Derek

_________________

[Masked Ranger]

Are there any big changes to 1.5 that is worth the trouble to upgrade?

[derek]

The simple answer is NO - unless you have purchased an Auto BiLevel with BiFlex. There is no added functionality that affects us end-users.

The reason for producing the new version of MyEncore is that I presume that Encore Pro 1.4 will soon not be available for purchase anymore.

[Guest]

That's what I suspect also since they are essentially the same price. The Auto does all the Bipap pro 2 does with the added feature of auto titration. So, who would still buy the bipap pro 2, a lesser machine? That said, when they sell all their supply of the pro 2, that will probably be the end of that machine. It's similiar to the AMD cpu. They've swapped to the 64 bit system now and 32 bit is becoming more difficult to find. As for people still using windows 98, I would suggest an update. Microsoft stopped supporting windows 95 a long time ago, 98 and ME will be next. My opinions.

[ozij]

Bravo, Derek!
O.

[kurrykid]

Hey Derek,

How's the upgrade going...after all it's been what, 3 days now Sorry to seem a little anxious but I am excited about the possibilities. Hopefully things are going well.

Thanks.

[sthnreb]

Me 2

[neversleeps]

kurrykid,

I'm wondering if perhaps you're wearing the straps on your mask too tightly. The compression widthwise seems to have elongated your face lenthwise, somewhat akin to squeezing a toothpaste tube in the center.

No offense...

[derek]

Things are progressing well. I have two Auto BiLevel databases and I can generate plots for them. The sleep statistics seem to be correct, however I am struggling with how to present the daily pressure data for the Auto BiLevel. There are both the EPAP and IPAP pressures to look after, and it seems to be highly "convoluted" in the data base.

I have found a table that lists "Min EPAP Setting", "Max EPAP Titrated", "Max IPAP Setting", "Max IPAP Titrated", "Ninety Percent EPAP", "Ninety Percent IPAP" pressures. No average EPAP and IPAP pressures that I can find - though I guess I could compute them for myself. Would one of you BiLevel experts please explain what the "Maximum xPAP Titrated" pressure might mean. Maybe I don't understand the Auto BiLevel operation...

[wading thru the muck!]

derek,

Here is a link to a thread in which the operation of the new auto bi-pap was debated. I can't say that the debate involved any "expert" commentary, but it may give you some further insight.

The way I understand it, the machine is set with a min & max for both IPAP and EPAP. There is also a max PS setting of between 3cm and 8cm that controls the max delta between IPAP and EPAP. There was a question of whether or not there is a min PS setting and if so, whether or not it can be set at a pressure outside of the 3-8cm PSmax range.

I would think that the following data outputs would be useful

- 90% IPAP
- 90% EPAP

- Ave IPAP
- Ave EPAP

- Minutes at or below ave IPAP
- Minutes at or below ave EPAP

...along with all the "event" data.


viewtopic.php?t=5437

[derek]

Thanks Wader - BTW, how did you tame your money to fly in and out of your wallet like that ? Mine just flies out and disappears (Buy a boat and you'll know what I mean)

[Guest]

The "Maximum xPAP Titrated" pressure" is the maximum the pressure reached on IPAP or EPAP since being used in an auto mode over a period of reported time. Mine is set at 18 Max but the titrated pressure max pressure has only reached 15.5, so that is the Maximum titrated pressure for IPAP. My printout for 2 days says: Maximum titrated IPAP pressure - 15.5 cm H20---Average device IPAP pressure = 90% of time is 12.0 cm---Maximum titrated EPAP pressure (the highest the EPAP got to) is 11.7 cm.-- Average device EPAP pressure = 90% of time is 10.0 cm---average time in apnea per day is 31.2 secs. I now have readings for 7 days in the auto mode and the Maximum titrated IPAP and EPAP are still 15.5 and 11.7 because that is the highest level either reached.
The Minimum EPAP setting is what the user sets in the provider mode. 4 cm is the lowest. Mine is at 6 now. So, a night begins at the lowest EPAP setting of 6 for me. The IPAP has always started 2 cm's higher making my beginning pressures 8/6. As I require more air to keep the airway open, it "titrates" or goes to a higher level to keep the airway open, whatever is required. The Max EPAP titrated then is the Max over all the EPAP pressure has reached over a period of time. The Max IPAP is the highest allowable amount for the machine to titrate to. So, it is not that important, set it high. Mine is at 18 cm and my max amount has only reached 15.5 titrated. The MAP keeps a running record of Minutes Air Pressure for each pressure change, IPAP and EPAP. It pretty much confirms my Rx settings of 12/8. I'm still working on the 90%. In some nights my AHI spread is 1.7 to 5.1. Hope this helps some.
BTW- My Max PS is set at 4 but a night begins with only a separation of 2 cm's H20--8IPAP/6EPAP. It will never separate more than the 4 cm, but mine begins with only a 2 cm difference.

[derek]

Gotcha - thanks Guest. The titrated values are worth plotting! As an aside I don't know why Respironics only reports pressures in intervals of 1 cm H20 for many of the parameters when the machine steps in 0.5 cm increments.

Now - to further display my ignorance: what is BiFlex? I certainly understand CFlex (I use it) but I thought it was the BiLevel that provided the exhalitory relief in BiPAP. Does BiFlex affect the EPAP pressure, or simply smooth the transitions?

[sthnreb]

Bi-flex affects both pressures. It is another form of relief like the bipap reduced epap effect. Whereas CPAP is constant pressure, BIPAP is a bilevel pressure. My settings are 12/8. On IPAP bilevel with biflex, it goes to 12 and then reduces to 11.5, back to 12 and when I exhale or EPAP, it reduces to 8 and then 7.5 and back to 8. I have the level set at 1 which provides the least relief. The settings are 1-3. Levels 2 and 3 progressively increase the pressure relief. I believe it is similiar to the cflex setting but I've never used a cflex so just guessing. It is just mainly for pressure relief from IPAP to EPAP for a much smoother transition. Of course the auto titrates the settings but the biflex is still active no matter what the pressures are.

Oh, that was my other post also, I wasn't signed in then.

No answers for the .5 steps and Respironics...

[Guest]

Derek,

Here's a URL that has a downloadable .pdf file that may explain a little about it.


http://www.respironics.com/search/index ... &x=20&y=11


Good luck.