Matt00926 wrote: ↑Sat Sep 25, 2021 8:10 am
dewfend wrote: ↑Fri Sep 24, 2021 11:06 pm
How do you guys think? Any comments are appreciated.
My setting:
Va target: 4.1L/min
Resp Rate: 13/min
Max EPAP: 6.0
Min EPAP: 3.0
Ti Min: 1.1S
Ti Max: 2.0S
Any reason your min EPAP is so low, and max EPAP so locked down? To minimize CO2 rebreathing in a simple vented mask setup, a min EPAP of 4cm h2o is recommended. Will also help prevent more obstructive events. The difference between 3 and 4 EPAP shouldn't make it any harder to exhale. If having a high EPAP is uncomfortable, you could turn off the auto-epap and just gradually raise your EPAP (so no max and min, just a set EPAP) until the obstructives go away. ResMed lets you make micro adjustments.
A set patient rate of 13bpm on iVAPS means the machine doesn't trigger a breath until you don't breathe, or breathe less than 2/3rds of 13bpm, so you are missing a ton of patient triggered breaths. Just because the machine will breathe for you, doesn't mean they are as efficient as patient triggered breaths.
I'd set your Ti min back to the default, and adjust trigger to be a bit more sensitive. Adjust cycle a bit lower if you feel inhalations getting cut off.
I still think you're on the wrong machine.
Thank you very much for your detailed analysis.
I put my setting in detail here below:
Va target: 4.1L/min
MV: 5.4L/min
Vt: 419 ml
Vt/kg: 7.0ml/kg IBW
Resp Rate: 13/min
Max EPAP: 6.0
Min EPAP: 3.0
Min PS: 0
Max PS: 14.8
Ti Min: 1.1S
Ti Max: 2.5S
Trigger: Low
Cycle: Very high
Full face mask
1) I set EPAP 3.0 in order to make my exhalation easier, I will follow your suggestion to EPAP 4.0 fixed and go higher gradually to eliminate OSA.
2) Sorry I don't understand well about
A set patient rate of 13bpm on iVAPS means the machine doesn't trigger a breath until you don't breathe, or breathe less than 2/3rds of 13bpm, so you are missing a ton of patient triggered breaths. Just because the machine will breathe for you, doesn't mean they are as efficient as patient triggered breaths.
, what should I do?
3) Inhalation trigger (Trigger), I set low because on medium setting I felt the machine was forcing me to inhale, I wanted to let my own breathing movement get air in my lung
Exhalation trigger (Cycle), I wanted to get pressure down immediately so I can exhale in easier way. I felt if no exhalation movement I will stop inhalation.
Ti min default is 0.9S? I set 1.1 because I feel my inhalation time longer than usual.
4) I will try to get an ASV machine
