What is 'Max Press Sup'

There is an a setting on the hidden setup menu of the 'M Series BIPAP Auto with BiFlex' called 'Max Press Sup'. It can be set to a maximum of 8.0 cmH20.

Can someone explain what the 'Max Press Sup' setting is for.
Thanks,
--Nelson

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Hi,

The Bipap Auto when in Auto mode, will adjust Epap (exhale) & Ipap (Inhale) CMS independently. This means they can each be adjusted to different pressures as the machines monitors you during the night.

To prevent the machine going rogue, you set a Max Pressure Support which is the maximum the two (Epap & Ipap) can roam apart during the night. The minimum is by default 2 CMS (you can't change this).

8 CMS is a very big gap & one only to ever be entertained with expert advice.

The max any normal (non COPD patient) should seriously set Max Press Sup to is 4 CMS). As mentioned, any greater than 4 CMS should be done with expert assistance.

Good luck

DSM

Thanks dsm...
Gotta love this forum...8 minutes to get a very thoughtful answer.
I appreciate that.

I'm not a doctor nor an expert, but I don't think there is a danger in setting the Max Press Sup as far as it will let you. Depending on what the EPAP/IPAP settings are, the maximum a person can set the Max Press Sup is 8 cm.

The BiPAP Auto, when auto-titration is enabled, operates very differently from how the traditional regular bi-level machine works.

While a regular bipap usually has the EPAP/IPAP set for a 3 or 4 or 5 cms fixed difference, the BiPAP Auto (when using auto-titration at the same time) is always going to start out using an IPAP pressure only 2 cms above the EPAP setting.

My explanation (not a doctor, not an expert) of how the Max Press Sup setting works is at the following link (it is called "PS" in the non-M series BiPAP Auto):

viewtopic.php?t=15666
Dec 08, 2006 subject: Question for BiPap users - UPDATED 12/14/2006

Everything I'm going to say from this point on is based on the assumption that a person will be either

1. using software to monitor his/her own treatment

or

2. will get a download done of the detailed data within the first week of using any machine that allows auto-titration.

Caveats about the number of cms difference which are usually set between a fixed IPAP setting and a fixed EPAP setting in a regular bi-level machine don't apply, imho, to the BiPAP Auto.

For a year, I've been using both the "classic" (non-M) BiPAP Auto and the M series BiPAP Auto. I've always set the Max Press Sup as much as it would allow (8 cm) and have never seen either machine actually use anywhere near that much separation. I do regular downloads. I've seen it use as much as 4 or 5 cms difference between EPAP/IPAP on a few occasions, but never anything approaching the max of 8 cms pressure support that I allow it.

An un-used ceiling is just that...un-used. But it's there in case ever needed. I want a very slack leash for the Max Press Sup, so I keep mine at the max -- an 8 cm difference, which, as I said, the machine has not even come close to using in a year.

In actual use for the vast majority of people, I don't believe the machine is going to use the full 8 cm difference often, if ever.

But if my machine DID use that much gap, I'd want to see it on the data. Capping the Max Press Sup at less than it will allow would not let me see what the EPAP/IPAP really might do in relation to each other.

Of course everyone should discuss such things with their doctor, but quite frankly I doubt if most doctors are very familiar with the way the BiPAP Auto operates. Most doctors, thinking of traditional "regular" bipap operation, would probably echo what the other poster said about the maximum gap to put between EPAP and IPAP.

The BiPAP Auto with Bi-Flex, however, when auto-titrating is enabled, operates very differently from traditional "bipap." I'd set the Max Press Sup for as much as it will allow.