[Equipment] O2 Pressure/Diverter Valve with VPaP and ClimateLine Heated Hose?

[gamegrrl]

I apologize in advance, but I'm still wrapping my brain around all the terminology. I hope I can state my questions clearly enough to get some input. 

I have a ResMed VPAP with ClimateLine heated hose. Tonight will be my first night using O2 while I sleep with the VPaP machine. The O2 guy came and set things up, but he was trying to jam a Pressure/Diverter Valve onto the end of the heated hose where it connects to my machine. The end that has the contacts that provide the connection to power/heat the hose.

It was obviously not going well, so I walked over and said, "Even if you get that to fit, it will cover/block the contacts and keep the hose from heating." He was totally baffled, and said, "Well, I guess you won't be able to use that then".

I'm new enough to all of this and have a healthy enough respect for O2 that I'm nervous about this. Here are my questions:

• Do I truly not need this valve?
  
• What risk, if any, am I taking if I don't have this valve, and is it dangerous?
  
• Is there a special valve made to do this job specifically for my machine/hose setup?
  

I have researched this online for nearly three hours tonight, but haven't been able to find an answer. You're my best hope right now.

I've been doing pretty good with the VPaP itself. Of course, I have good nights and bad nights, but even my WORST nights are better (from an AHI standpoint) than either of my sleep studies. My AHI is always under 2, usually under 1 and I have even hit several zeros! And that is over about a 65 day period of use.

Unfortunately, managing the apnea itself hasn't solved my nighttime desaturation issue. During the sleep studies, I dropped to the low to mid 60s many times. They set me up with the VPaP, then after a month had me use a recording pulse oximeter overnight at home, and they came and picked it up. Next thing I know, I get a call saying I'm being put on 2 LPM of O2 while I'm sleeping. I am hoping that the addition of O2 will make me feel even better.

In the meantime, here I am with my O2 concentrator all set up and ready to go, but I'm afraid to use it because of the valve the guy couldn't figure out. I was really, REALLY looking forward to sleeping with O2 tonight, but I prefer to err on the side of caution when dealing with potentially dangerous stuff, particularly when there are holes or gaps in the setup process.

Thoughts?

[Sleeprider]

Resmed makes a Climateline tube with an oxygen bleed adapter built in. It costs about $55 and your DME should be able to provide it. It is called Climateline Oxy Tubing.

[gamegrrl]

Thanks for your reply. Yes, that is the ClimateLine hose I have with the Oxygen Connector Port. The guy setting up the equipment was trying to add an Oxygen Diverter Valve.

Here is all I was able to find on the ResMed site:

Q. How do I set up oxygen with an AirSense™ 10 or AirCurve™ 10 device?

A. If you require oxygen, you will need to use an oxygen port. ResMed recommends using the Oxygen Connector Port, but an Oxygen Side Port Connector may also be used. Note: An Oxygen Diverter Valve can be set up to reduce oxygen build-up in the device if oxygen continues to flow when the therapy device is on standby, or off. If you're using the Standard or SlimLine™ air tubing, we recommend that you place the oxygen port between the device and the air tubing. If you're using the ClimateLineAir™ heated tubing, then the port will need to be fitted between the tubing and the mask.

I can't tell from reading this, but are they MAYBE saying that if you're using the Oxygen Connector Port built in to the ClimateLine Hose like I have, that you don't NEED the Diverter Valve?

[eseedhouse]

I can't tell from reading this, but are they MAYBE saying that if you're using the Oxygen Connector Port built in to the ClimateLine Hose like I have, that you don't NEED the Diverter Valve?

All I know is on my Resmed machine the DME just stuck on an adapter with a little bit sticking out where the oxygen hose fits.  There's nothing on the other end of my hose, the oxygen comes into the mask about an inch from it.  I have no idea why one would need a "diverter valve" or even what one is!

[Sleeprider]

There is no reason for a diverter valve. Even at 30 cm pressure, the oxygen hose has enough pressure to feed the CPAP hose the 2 Lpm of oxygen. All the "diverter" does is provide a port, in fact you won't find it called a diverted anywhere; the correct term is oxygen bleed adapter. When oxygen enters the CPAP hose it is diluted with the respiratory air + vent air, so you are receiving much less oxygen than if you used a canula, and the pulmonologist should be aware of this. You may have a respiratory minute vent of 6-7 Lpm, but your VPAP is providing over 30 Lpm.

In any event, there is nothing technical about the oxygen bleed system, as the O2 addition is entirely controlled by the generator or regulator. As long as there is a tight connection at either the hose by the CPAP or by the mask, the O2 supplement is delivered at the prescribed dose.

[gamegrrl]

I called my Respiratory Therapist this morning, and she is looking into it. I'll report back. It's a valve to prevent the backflow of O2 into the machine.

[Sleeprider]

That's fine, but rarely used. The VPAP produces a lot of flow towards the mask, and it moves that direction even during exhale. It would take a large surge of flow, like a cough or sneeze to cause a reverse flow situation with the machine on. The diverter valve is only effective when the machine is off and oxygen is connected. This is what Resmed says on the matter: http://w ww.resmed.com/us/en/healthcare-professional/airsolutions/air-solutions-support/device-faqs.html

Q. How do I set up oxygen with an AirSense™ 10 or AirCurve™ 10 device?

A. If you require oxygen, you will need to use an oxygen port. ResMed recommends using the Oxygen Connector Port, but an Oxygen Side Port Connector may also be used. Note: An Oxygen Diverter Valve can be set up to reduce oxygen build-up in the device if oxygen continues to flow when the therapy device is on standby, or off. If you're using the Standard or SlimLine™ air tubing, we recommend that you place the oxygen port between the device and the air tubing. If you're using the ClimateLineAir™ heated tubing, then the port will need to be fitted between the tubing and the mask.

[gamegrrl]

Great minds think alike     That's the same info I posted from their site, above.

So I got a call back from the Respiratory Therapist. The valve is simply not needed. Yay. I can stop thinking about it.