Feeling like I cannot breathe

[SarcasticDave94]

If you prefer ASV, then that's fine. It's not my decision to make. ASV will treat Central Apnea, and in doing so will also treat Obstructive Apnea and Hypopnea. It's also easier for us non-doctors to understand and edit settings. Which I think even you can do yourself with coaching here if needed.

Note this though, while ASV does stand for Adaptive Servo Ventilator, this is not a ventilator that assists breathing. If just treating CA plus the rest of Apnea events is good enough, then this is fine. However, if you're in need of a ventilator to assist breathing, ASV isn't going to cut it. In ResMed's family, the ST-A could do it as it has a version of AVAPS ventilation mode, but it really is officially only the Astral that's counted as full on ventilator duties. I'm skipping the Stellar series.

[vgrando]

Thank you!  You are correct; I was not tested on a ventilator. I am not sure why my MD is ordering a ventilator. Can you explain the difference between a Resned ASV and a ST-A? 

I read that: [color=var(--m3c9)]Search Labs | AI Overview[/color]
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[color=var(--m3c11)][color=var(--m3c11)]The ResMed BiPAP-ST-A is a bi-level machine that provides non-invasive ventilation for patients with respiratory insufficiency such as neuromuscular disease, restrictive lung disorders, severe COPD, and hypoventilation syndromes. It features iVAPS, ResMed's proprietary mode that automatically adapts to each user. The iVAPS mode is designed to target a patient's minute ventilation and auto-adjust to maintain a patient target and improve blood gas levels, even when their RR changes throughout the night. The Intelligent Backup Rate (iBR) maximizes your freedom to breathe spontaneously. 


I have also read that an ASV is not for patients with hypoventilation and neuromuscular disease. I have been diagnosed with both of these. 

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[SarcasticDave94]

As long as we're talking about the same ResMed AirCurve 10 series, or the newer 11 series respectively, both ASV and ST-A are physically very similar. One exception is the ST-A has a slim black alarm sound and light module on top. And the ST-A power port has a lock to prevent disconnecting it, located on the back of the machine.

ASV has different programming that specifically is after Central Apnea. Its therapy settings will include up to EPAP range, PS range, and then IPAP range that's the sum of EPAP plus PS. ResMed ASV does not have any manual timing controls pertaining to breathing or treatment.

ST-A has the iVAPS mode that's mentioned in your quote above. This is a ventilator mode, ResMed's version of AVAPS. I have trialed this myself from a borrowed device a few years ago, so some info is somewhat sketchy. There's more or less the full complement of timing controls, includes backup breath rate to trigger breath assistance, there's input for inhale duration possibly Ti Min and Max, there's a Trigger setting to change sensitivity to trigger inhale, Cycle sensitivity to return to exhale. And so on.

The ASV will treat Central, Obstructive, Hypopnea, but the focus is CA. Backup breath rate is focused to help during a CA breath pause to jolt the patient into a breath, not quite the same as the ventilator.

To assist you, attached is a screenshot of the clinical manual on the available settings in the ST-A.

ST-A modes and pertaining settings

   

iVAPS mode description from ResMed's clinical manual

   

Table from ResMed to give brief description of their machines, including ASV and ST-A

   

PS if your neuromuscular disease hinders breathing, this can be a reason for a ventilator style machine.

Feel free to screenshot the images to show the doctor, in helping get the right machine.

[vgrando]

Thank you. I made screenshots from the MD's recommendations. From what I read, he states that an ASV was used, not a ventilator.

[SarcasticDave94]

Yes, definitely an ASV. If that's good enough to treat you, and you and doctor are satisfied, that's all to ask for then.

My opinion, if that's what you're getting, ask by name for the ResMed AirCurve 10 ASV. I've used one a few years ago until COPD kicked up a bit.

It's easy to edit settings, it'll take care of all Apnea. Negatives would be no manual timing controls, which for you may not be an issue.

We can assist with settings if needed, once you get this.

Best wishes you get something soon.

[vgrando]

Thank you. This is what I think. He recommended ASV settings, not ventilator settings, and the AVS worked well.

[vgrando]

Good news! I purchased a new Resmed Aircurve 10 ASV at a great price, and it is on its way.

[SarcasticDave94]

OK sounds like a bit of progress. Let us know when you get it.

I would try this setup:

Mode ASV Auto
EPAP Min between 5 and 7, Max 10 to 12
PS 3-15
Note IPAP isn't manually edited, it'll be set in reflection of EPAP plus PS.

Try to go No Ramp. Set humidity and heated hose if applicable as you see fit.

[vgrando]

[vgrando]

Yea! It is here, and I set it up as you suggested. No Issues with setup just like my BiPap Auto.. I am keeping the Bipap Auto for travel.  Thus I do not have to disturb my home setup!!!