Talk To Me About Resmed's VPAP Pressure Support

Thanks, dsm! That helps. Pic vs. 1,000 words, and all that. (And even I get tired of reading my long-winded posts sometimes! )

jnk wrote:
Maybe ResMed's wording makes sense to those who speak Australian. *

jeff

* [Note: Please ignore my shameless attempt to start a flame war (or maybe just a spark skirmish) with dsm and his kin. ]

I bet that's it - ResMed manuals are written in Australian!

Bluebonnet_Gal wrote:

jnk wrote:
Maybe ResMed's wording makes sense to those who speak Australian. *

jeff

* [Note: Please ignore my shameless attempt to start a flame war (or maybe just a spark skirmish) with dsm and his kin. ]

I bet that's it - ResMed manuals are written in Australian!

Hey youse, I read them manuals un I didn't think they read weird. Dunno bout youse but I cud read em quite clearly
I rekon youse r just gripin cos it took an Aussie to invent the bloody things

DSM
(who really does speak the Queens prep school Anglish having been tutored in elocution classes to enunciate words with the utmost clarity vs me mates who are typical Aussies speakin with their moufs mostly closed (which in turn started with the fly plagues that no longer seem to hit us ) )

dsm wrote:

ozij wrote: <snip>

But as a side comment PS= 5 goes against my good judgment as a valid setting esp with your Min Epap set as low as it is. I would hope the RT thought very carefully about such a wide spread between epap & ipap when epap is set so low.

I don't understand what's wrong about the spread. If a person with COPD needs help both in breathing in (IPAP) and exceptional support for breathing out (low EPAP) I see nothing wrong with the spread.

>>> My concern would be if Slinky has any OSA compoanent (which I believe is the case) in which case an epap as low as 6 + a big spread tends to exacerbate othe OSA.

COPD stands for Chronic Obstructive Pulmonary Disease. The obstructions in OSA are transient.

Priority is given to the Max IPAP setting, followed by Min EPAP and then
Pressure Support. The device automatically adjusts the lower-priority settings to
ensure the device pressure limits are not exceeded.

Bear in mind that I have never held any kind of bi-level in my hands, let alone set it or breathed with it.

Jeff's explanation about the way the data is presented seems to me to very much to the point.

Note what Jeff said about PS: On a Resmed, the pressure support itself will not vary during the night - once you've set it, its set. And, since your max IPAP is equivalent to EPAP + Pressure Support, then by definition, the pressures won't vary either.


>>>> The way PS works is that it combined with epap Min sets the bilevel pressure operation say PS=4 & epap Min = 8 then IPAP (not Ipap Max) will equal 12. Ipap Max if set above 12 (say 16) sets the upper limit the ipap can float too as events are detected. As ipap floats up in response to events, epap follows at exactly PS CMs below IPAP.

Yes. The "you" in my sentence referred specifically to Slinky and her IPAP=11 EPAP=6 PS=5 settings. I think we agree that on those setting, there was no room for variabilty.

Thanks for the pics!
With the "Autoset Pressure" being a conceptual line, I don't see why the above setting (IPAP=11 EPAP=6 PS=5 settings)should not show as a stable 6+2.4 line on the chart. I guess I missed something - I'll re-read and re-edit if necessary.
O.

EXACTLY WHY I do NOT think that this VPAP Auto is acting correctly! But the Resmed Rep said it IS. I don't buy it but .... thankfully my DME's RT did say that if I'm still convinced it isn't he will go over the Rep's head right straight to Resmed directly. That just might be what we are going to do. We shall see.

UNFORTUNATELY, I started doing as the manual suggested and started Erasing Data prior to each therapy setting change so its not like they are going to have a nice long history via the machine itself if and when we do send it in. I have all the detailed data from almost every night since I started using it - but that would be more than a ream of paper to send the data via hardcopy.

And, yeah, dsm ..... I HAVE done SOME experimenting ..... not much, but some .... not like I did when in straight CPAP.

And by the by ... I feel one h*ll of a whole lot better this AM w/that change to IPAP 13. Doctor didn't mention PS, just IPAP 13 so that's all I changed.

But, yech! My mouth wasn't dry when I woke but it was a bit sticky. AND I must have been "chomping" in my sleep or something - or maybe it was "just" the "lip flutters" but I drooled last night. Yecky, sticky drool on my lips which were sealed shut w/the sticky drool. And out one corner of my mouth stuck to my chin strap and even the headgear strap on that side. BLECH! Gross!

Congrats at feeling better Slinky. And now, since you've raised the IPAP Max you "conceptual Autoset pressure" should show some meandering as well... - if the machine is functioning in Auto mode

O.

dsm wrote:

Bluebonnet_Gal wrote:

jnk wrote:
Maybe ResMed's wording makes sense to those who speak Australian. *

jeff

* [Note: Please ignore my shameless attempt to start a flame war (or maybe just a spark skirmish) with dsm and his kin. ]

I bet that's it - ResMed manuals are written in Australian!

Hey youse, I read them manuals un I didn't think they read weird. Dunno bout youse but I cud read em quite clearly
I rekon youse r just gripin cos it took an Aussie to invent the bloody things

DSM
(who really does speak the Queens prep school Anglish having been tutored in elocution classes to enunciate words with the utmost clarity vs me mates who are typical Aussies speakin with their moufs mostly closed (which in turn started with the fly plagues that no longer seem to hit us ) )

ROFL!!!

Actually, one of my favorite TV shows is Australian. I became a HUGE fan of McLeod's Daughters when it aired here in the US on WE (Women's Entertainment Network). Took me a few weeks to get used to the accent and terminology (ie "mate" = "friend" - "bloke" = "guy" or "dude" - "randy" = hmmmm, well, you know! ), but it was worth it! Since WE took it off the air, I "did without" for a while. Now Netflix offers the series for rental so I started renting the series from where WE dropped it. I understand the series has ended after 8 seasons. I just started Season 6 so I still have quite a few episodes to look forward to!

ozij wrote:Congrats at feeling better Slinky. And now, since you've raised the IPAP Max you "conceptual Autoset pressure" should show some meandering as well... - if the machine is functioning in Auto mode

O.

And once you get your ResLink back up, your software should show the jagged sqigglies of inhalation and exhalation like you are used to seeing, too.

Well, maybe its just the pressure that needs adjusting. Last night was IPAP 13, EPAP 6, PS 6 and whilst my data doesn't look so hot I sure as the devil FEEL one heck of a whole lot better! And, yup, I did have some minor fluctuation in the graphs and the Statistics. With this COPD and the fluctuations w/just it from day to day maybe I just need a larger pressure range than most people. We shall see. One night does not the entire story tell. (Gads how I hate the one week wait to get an accurate picture of how effective this change will truly be!). I'm a such an impatient patient!!! Median 9.8 cms, 95th Percentile and Maximum 10 cms.