Thanks, -SWS. And (((hugs))) I don't see my pulmo until August - unless I call and TRY to get past his desk dragons. They never wanna bring you in sooner than 3 months from when you call. *snort* I"m off to read the link you provided.-SWS wrote:... The nausea was probably symptomatic of hypercapnia secondary to having reduced your respiratory drive.
As reference of what I just described, see the yellow text I have highlighted in this book: BASICS of BLOOD MANAGEMENT, by Petra Seeber and Aryeh Shander.
You know what, Slinky? I think you should ask your doctor to arrange a trial on iVAPS or AVAPS on that next visit. It sounds as if it's time to start nudging those CO2 levels down.
New machine - iVAPS
Re: New machine - iVAPS
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| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
Re: New machine - iVAPS
Unfortunately I don't have time to dig through the Resmed iVAPS patents for comparison. Maybe this winter.jnk wrote: Any iVAPS-vs.-AVAPS scouting reports at this point from what you've read/heard/seen, -SWS? Or do we just have to wait?
Both machines offer Pressure Support ventilation modes. But the Stellar 150 doesn't offer the volume modes of ventilation that your Trilogy can do. Think of the Stellar 150 as being more similar to the AVAPS machine (PRS1 non-Trilogy model) or the S9 VPAP S/T-A---but with better portability (internal battery) and a more feature-rich & data-rich user interface on the LCD.Madalot wrote:I just did a quick search for ResMed's Stellar 150 Ventilator (which has iVAPS). The information I could find wasn't as detailed as I would like so I'm asking.... Is this ResMed's equivalent (or comparable) to Respironics Trilogy series?
Hugs back, old friend. Does your pulmo know what happened when you tried to up to 4L of O2? If not, I think you should get that information to the pulmo before the August appointment. Also, consider faxing, emailing, or dropping off hard-copy of your proposal to trial iVAPS or AVAPS well in advance of your next appointment. That gives the pulmo time to analyze and consider the COPD-targeted treatment you propose to trial. I'd also suggest asking the pulmo if he/she can arrange to measure CO2 retention during sleep. Good luck, Slink.Slinky wrote: Thanks, -SWS. And (((hugs))) I don't see my pulmo until August - unless I call and TRY to get past his desk dragons. They never wanna bring you in sooner than 3 months from when you call. *snort* I"m off to read the link you provided.
Last edited by -SWS on Fri Jun 07, 2013 3:39 pm, edited 1 time in total.
Re: New machine - iVAPS
This looks like a fairly up-to-date general home vent guide:
http://www.ventusers.org/edu/HomeVentGuide.pdf
http://www.ventusers.org/edu/HomeVentGuide.pdf
Re: New machine - iVAPS
Thank you VERY MUCH, Jeff. I printed this and will read it this afternoon!jnk wrote:This looks like a fairly up-to-date general home vent guide:
http://www.ventusers.org/edu/HomeVentGuide.pdf
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| Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear |
| Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand |
| Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7 |
Re: New machine - iVAPS
Thanks, jnk. I see from that comparison chart that Resmed now offers an S9 VPAP COPD model:
http://www.resmed.com/us/products/vpap_ ... nc=dealers
That S9 VPAP COPD is probably less expensive than the more versatile S9 VPAP ST-A w/iVAPS machine. Apparently what differentiates the S9 VPAP COPD model from the ordinary S9 VPAP-S is that the settings are all defaulted to COPD-typical values, to be used as INITIAL settings that require follow-up customization (IPAP, EPAP, TiMax, TiMin, Rise Time, Trigger Sensitivity, Cycle Sensitivity, PS). That's also what happens with settings when the S9 VPAP ST-A w/iVAPS is placed in COPD treatment mode: COPD-typical settings are defaulted as a starting point requiring patient-specific customization. Those COPD-typical settings encourage CO2 depletion in COPD patients. Additionally the higher PS value will mechanically offload more COPD-related work of breathing (WOB) than a lower PS setting would.
The possible show-stopper for you, Slinky, is that the S9 VPAP COPD model has no backup rate. And if you and your doctor are going to endeavor adding more oxygen, then it might be a good idea to use a machine with a backup rate to compensate for the iatrogenic respiratory-drive response we discussed a few posts up. The volume assurance of iVAPS or AVAPS (but not offered on the VPAP COPD model) probably isn't a bad idea either. Slinky, I'd also suggest asking the doctor if it's a good idea to gradually edge up from 2L O2, allowing plenty of time for your respiratory drive to adapt to each smaller increment of supplemental O2. As COPD patients perfuse less O2 and retain more CO2 over time, their respiratory drives essentially re-adapt to those gradually changing chemoreceptor inputs (O2 and CO2). That gradual re-adaptation sometimes makes hypercapnic COPD patients more prone to an acutely reduced respiratory drive in response to supplemental O2.
http://www.resmed.com/us/products/vpap_ ... nc=dealers
That S9 VPAP COPD is probably less expensive than the more versatile S9 VPAP ST-A w/iVAPS machine. Apparently what differentiates the S9 VPAP COPD model from the ordinary S9 VPAP-S is that the settings are all defaulted to COPD-typical values, to be used as INITIAL settings that require follow-up customization (IPAP, EPAP, TiMax, TiMin, Rise Time, Trigger Sensitivity, Cycle Sensitivity, PS). That's also what happens with settings when the S9 VPAP ST-A w/iVAPS is placed in COPD treatment mode: COPD-typical settings are defaulted as a starting point requiring patient-specific customization. Those COPD-typical settings encourage CO2 depletion in COPD patients. Additionally the higher PS value will mechanically offload more COPD-related work of breathing (WOB) than a lower PS setting would.
The possible show-stopper for you, Slinky, is that the S9 VPAP COPD model has no backup rate. And if you and your doctor are going to endeavor adding more oxygen, then it might be a good idea to use a machine with a backup rate to compensate for the iatrogenic respiratory-drive response we discussed a few posts up. The volume assurance of iVAPS or AVAPS (but not offered on the VPAP COPD model) probably isn't a bad idea either. Slinky, I'd also suggest asking the doctor if it's a good idea to gradually edge up from 2L O2, allowing plenty of time for your respiratory drive to adapt to each smaller increment of supplemental O2. As COPD patients perfuse less O2 and retain more CO2 over time, their respiratory drives essentially re-adapt to those gradually changing chemoreceptor inputs (O2 and CO2). That gradual re-adaptation sometimes makes hypercapnic COPD patients more prone to an acutely reduced respiratory drive in response to supplemental O2.