Inhale & Exhale Pressure settings

Worksfire1 · Post by **Worksfire1** » Tue Apr 21, 2020 10:47 pm

My brother has been in the hospital for 8 months on a ventilator. He has worked very hard in physical therapy to regain his strength after being bed-ridden in a medically induced coma so he can come home, but he needs a bipap machine and no one is doing sleep studies in the nation because of aerosol risks to staff. Insurance bull crap red tape. So i came up with the idea of buying used on ebay. Any other site suggestions are appreciated! This is where you come in. He is begging to come home. But i have to have his airway protected first and foremost. The hospital says his ventilator was set on virtually bipap settings towards the end of the wean. But they took the trach out right as corona exploded and didn’t realize sleep centers would be closed. He has no breathing support now for almost 3 weeks. I just realized i can buy a machine for a reasonable price outside of the medical supply industry.

I asked for his inhale pressure setting and his exhale pressure setting. Alarmingly the Respiratory Techs did not understand what i was asking for. They did come up with 2 numbers though. “Pressure Support = 10” and “PEEP = 5”. Does anyone know if/how they relate to what I need? PEEP stands for “Positive End-Expiratory Pressure” so is that Exhale Pressure? I read somewhere that “Pressure Support is the difference between exhale pressure and inhale pressure”, so does that mean his Inhale Pressure is 15?

IP-EP=PS would be 15-5=10

Any second hand site recommendations for clean, low hour Bi-Pap or Auto Bi-Pap machines is greatly appreciated if allowed, of course!

Pugsy · Post by **Pugsy** » Wed Apr 22, 2020 7:05 am

A PS of 10 would normally be used under specific circumstances where there is significant respiratory issues.
I would do that only under the direction of a pulmonologist doctor and not rely on a RT.

For most people using bilevel machines a PS of 3 to 5 is going to be the most common settings used.
A PS of 10 could cause some problems and I just wouldn't recommend it unless there are significant respiratory issues or neurological issues and a doctor was involved.

Check out secondwindcpap.com for good quality low hour clean machines. Good people there.

DreamDiver · Post by **DreamDiver** » Wed Apr 22, 2020 7:34 am

Worksfire1 wrote: ↑
Tue Apr 21, 2020 10:47 pm
My brother has been in the hospital for 8 months on a ventilator. He has worked very hard in physical therapy to regain his strength after being bed-ridden in a medically induced coma so he can come home, but he needs a bipap machine and no one is doing sleep studies in the nation because of aerosol risks to staff. Insurance bull crap red tape. So i came up with the idea of buying used on ebay. Any other site suggestions are appreciated! This is where you come in. He is begging to come home. But i have to have his airway protected first and foremost. The hospital says his ventilator was set on virtually bipap settings towards the end of the wean. But they took the trach out right as corona exploded and didn’t realize sleep centers would be closed. He has no breathing support now for almost 3 weeks. I just realized i can buy a machine for a reasonable price outside of the medical supply industry.

I asked for his inhale pressure setting and his exhale pressure setting. Alarmingly the Respiratory Techs did not understand what i was asking for. They did come up with 2 numbers though. “Pressure Support = 10” and “PEEP = 5”. Does anyone know if/how they relate to what I need? PEEP stands for “Positive End-Expiratory Pressure” so is that Exhale Pressure? I read somewhere that “Pressure Support is the difference between exhale pressure and inhale pressure”, so does that mean his Inhale Pressure is 15?

IP-EP=PS would be 15-5=10

Any second hand site recommendations for clean, low hour Bi-Pap or Auto Bi-Pap machines is greatly appreciated if allowed, of course!

There are so many reasons why, at the very least, you should consult the pulmonologist MD who was in charge of your brother's ventilation therapy and ask for guidance. Maybe by phone or even zoom meeting. If your brother needs to be on bipap 24-7, it's a different consideration than just sleep apnea. If lung damage was involved (acute smoke inhalation and burnt or scarred lung tissue for example) there may be extenuating circumstances. It's possible your brother's pulmonologist will suggest a home titration, but this may be outside the purview of sleep apnea. Be persistent and get some time chatting with the doctor. I hope you find answers.

I'd also like to say it's amazing that your brother has a patient advocate (you) willing to go to bat for him. Thank you for being there for him.

palerider · Post by **palerider** » Wed Apr 22, 2020 7:52 am

Worksfire1 wrote: ↑
Tue Apr 21, 2020 10:47 pm
My brother has been in the hospital for 8 months on a ventilator. He has worked very hard in physical therapy to regain his strength after being bed-ridden in a medically induced coma so he can come home, but he needs a bipap machine

Why does he "need a bipap (actually a bilevel) machine"?

The settings you got sound like what he's had on a ventilator, which are different.

Miss Emerita · Post by **Miss Emerita** » Wed Apr 22, 2020 11:09 am

If he is still in the hospital, they don't need to do a sleep study to trial him on a bi-level machine. It is far, far preferable that the medical team at the hospital gets him on the machine and settings that he will need when he comes home. I hope you can push them hard on this.

Inhale & Exhale Pressure settings

Inhale & Exhale Pressure settings

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Re: Inhale & Exhale Pressure settings

Re: Inhale & Exhale Pressure settings

Re: Inhale & Exhale Pressure settings