How does EPR work ??

Spirit · Post by **Spirit** » Fri Sep 04, 2009 4:30 pm

Hi,
I like the EPR feature, but don't understand it. If pressure reduces with exhalation, does inhalation stay constent ? Is it automatic, whlie we breathe ? Or do we need to breathe, according to the timing of the cpap ?

Cause even using EPR, I can feel a constent pressure, through air vents.

When I turned off the EPR feature, felt like a hurricane passing through my mouth, when I turn it on, seems like I'm not recieving any pressure at all, when I open my mouth, a bit confusing.

When I ran this test mode, ramp feature was turned off.

My pressure is set to 8cm, EPR level 3,.

Can someone please educate me on EPR ? Or share a link, I can read about it.

Thanks.

jdm2857 · Post by **jdm2857** » Fri Sep 04, 2009 6:04 pm

I don't know the details but I do know that all types of CPAP and APAP exhalation relief (EPR, C-Flex, and A-Flex) sync to the user's breathing.

The only machines that use timing to try to stimulate the user to breathe are some of the more complex bilevel machines.

midnightdweary · Post by **midnightdweary** » Fri Sep 04, 2009 6:14 pm

I don't know all the technicalities, but the pressure is dropped during exhalation so that the problem that some have of finding it difficult to breathe against a constant pressure is supposedly solved or lessened.

I use a setting of 1 for some reason. It resulted from experimentation. I just found it better suited me, after trying a setting of 2 for a couple of weeks.

My pressure is similar to yours, and I keep a spread of about 3.5 between my min and max settings.

jnk · Post by **jnk** » Fri Sep 04, 2009 7:29 pm

http://www.resmed.com/au/patients_and_f ... elief.html:

How does EPR work?

. . . The S8 flow generator device detects the beginning of exhalation and reduces motor speed to drop pressure. The patient or clinician chooses one of three comfort levels to determine the degree by which pressure will drop.

Setting 1 = mild comfort (1 cm H20)
Setting 2 = medium comfort (2 cm H20)
Setting 3 = maximum comfort (3 cm H20)

https://www.cpap.com/DisplayNewsletter/22:

Respironics C-Flex vs. Resmed EPR: There Is A Difference

Many similarities exist between Respironics C-Flex and Resmed EPR but they are NOT the same thing! Both are easy breathing, expiratory pressure reduction systems. Both decrease the pressure to the patient at the beginning of each exhalation and both have three comfort settings. However, major differences exist . . .

. . . C-Flex decreases pressure at the beginning of each breath. The decrease lasts for less than a second and then returns to the base pressure. EPR decreases the pressure at the beginning of each breath also but keeps the pressure low throughout the exhalation.

. . . C-Flex settings reduce the pressure relative to the patient’s exhalation strength and the machine pressure setting. EPR reduces the pressure by one, two or three centimeters of water pressure.

. . . EPR has an Event Detection Circuit. When a sleep disordered breathing event is expected or has occurred, EPR stops until the event concludes and normal breathing resumes. C-Flex is of such short duration it is thought that is has no negative effect on sleep disordered breathing events and does not need to stop.

. . . So, if EPR reduces the expiratory pressure by a controlled 1, 2, or 3 centimeters, what is the difference between EPR and BiPAP (tm) or Bilevel?

Bilevel machines are categorized as "ventilatory devices". They use rapid pressure changes to expand and contract lung volume. EPR uses slower pressure changes, so there is little ventilatory effect. However, EPR does feel very much like a Bilevel to the patient.

Spirit · Post by **Spirit** » Sat Sep 05, 2009 4:36 am

Thanks for replies & links.

dsm · Post by **dsm** » Sun Sep 06, 2009 5:02 pm

The real difference between Bilevel and EPR is related to what pressure the machine treats as its default pressure.

Bilevels go to epap pressure as the default whereas EPR switches to ipap as the default. The speed of change in pressure is not a real differentiator, just that with EPR it is not adjustable whereas with most bilevels speed of change is (as ristetime).

Put another way, EPR when it detects events goes to Ipap pressure & stays there. Bilevels regard epap as the base & will stay there if some types of events are detected (very much defendant on brand & model).
Cheers

DSM

How does EPR work ??

How does EPR work ??

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