Help with Resmed Malibu VPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
xzombie
Posts: 41
Joined: Mon Oct 03, 2005 3:13 pm

Help with Resmed Malibu VPAP

Post by xzombie » Mon Dec 01, 2008 10:54 am

Finally convinced my Dad to get tested and he did but he's having trouble with his new machine. He tells me he doesn't feel any different - still sleepy all the time. I managed to access the clinical menus and here's what I found:

Setting Value
Mode Vset
Press Sup 4
ASET max 20
ASET min 5
IPAP Max 2.8s
IPAP min .5s
Exhalation med
Trigger med
Cycle med
Max Settle off

Result Day Wk Mth
Leak 12 l/min 12 l/min
VT 400-600 350-650
Resp Rate 15-20 16-21
MV 7.4-11.6 7.1-0.0 6.9-11.8
Press 13.2 13 11.8
AHI 12.3 12.6 11.2
AI 1.4 1.1 3
Usage 5.3 4.3 5.2

Right off I notice two things: AHI higher than what it should be and the low usage (probably because of the high AHI).

I suspect the machine's clearing the apnea's (AI <=3) but not the Hypopnea's (hence the 12 AHI). And I suspect it could be tweaked to fix that but not sure what some of these settings and measures are? I've guessed on some but other's I'm not sure.

Would that be in the clinical manual? Does someone have one they can send me?

Thanks.

Sorry, I couldn't get the table to line up nicely.

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LoQ
Posts: 1475
Joined: Sun Apr 06, 2008 1:59 pm
Location: America

Re: Help with Resmed Malibu VPAP

Post by LoQ » Mon Dec 01, 2008 8:38 pm

Code: Select all

Result 	Day 		Wk 		Mth

MV 	7.4-11.6 	7.1-0.0 	6.9-11.8
Press 	13.2 		13 		11.8
AHI 	12.3 		12.6 		11.2
AI 		1.4 		1.1 		3
Usage 	5.3 		4.3 		5.2
Maybe this is better. I took out some rows that didn't seem to have the same number of columns. It's not perfect, but more readable, at least on my browser in preview mode.

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rested gal
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Joined: Thu Sep 09, 2004 10:14 pm
Location: Tennessee

Re: Help with Resmed Malibu VPAP

Post by rested gal » Mon Dec 01, 2008 9:38 pm

I'm not a doctor, but if it were me, I'd change these two things:

ASET min 5 -- I'd set the min at 8 or 9 if raising the minimum pressure doesn't bother him.
IPAP Max 2.8s -- I'd set that for as as high as it allows.
ResMed S9 VPAP Auto (ASV)
Humidifier: Integrated + Climate Control hose
Mask: Aeiomed Headrest (deconstructed, with homemade straps
3M painters tape over mouth
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dsm
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Location: Near the coast.

Re: Help with Resmed Malibu VPAP

Post by dsm » Mon Dec 01, 2008 11:06 pm


Setting Value
Mode Vset
Press Sup 4
ASET max 20
ASET min 5
IPAP Max 2.8s
IPAP min .5s
Exhalation med
Trigger med
Cycle med
Max Settle off
{/b]

Just a few comments re the meaning of these ...

Vset the auto dual pressure mode (the actual 3 modes supported are: CPAP, S and VSet modes) - When 'VSETL' shows in the LCD the machine is in 'settling' mode. When it is out of settling, the word VSETL goes away (shd show Vset). Settling is like ramp is in CPAP mode. It allow the machine to remain at min pressure so the user can get to sleep, then the machine activates normal Auto mode. 'S' mode is normal Bilevel mode (no auto ranging). CPAP is of course normal fixed pressure CPAP operation.

PS 4 sets the pressure gap between inhale and exhale (3 or 4 are good choices)

ASET max is the highest pressure the machine will go to
ASET min is the starting pressure the machine 1st works at (### As RestedGal suggests, up it to around 9)

IPAP Max 2.8s is the maximum time in seconds to remain in inhale mode - shown on the LCD as TiMx (max setting can be 4.0)
IPAP min 0.5s is the minimum time the machine will remain in inhale mode - on the LCD as TiMn (min setting is 0.5)
(again RestedGals suggestion to set IPAP max to maximum (4.0) is ok as the machine in VAuto mode uses the sleeper's spontaneous breath to change out of IPAP (inhale) but the IPAP max when set higher (e.g. than 2.8s ) just allows for slower longer breaths before the machine arbitarily switches out of IPAP (inhale) and into EPAP (exhale).

Exhalation, Trigger & Cycle are comfort settings to do with how soft or firm the breathout, switching from inhale to exhale & the reverse, feel

Hope this helps

DSM
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)