Going Back To My DS1 BIPAP Auto SV After Trying Resmed AC 10 ASV for 4 Months

[Sleeprider]

The default backup rate came from this old post of mine where I cite the clinical manual. I have not looked recently, but I assume that remains true. I did not just invent the language below. http://www.apneaboard.com/forums/Thread-...#pid231058

The Resmed Aircurve 10 ASV is adjustable in pressure from a minimum of 4.0 to maximum IPAP of 25.0 at increments of 0.2. Pressure Support is adjustable from zero to 15 cm. The backup rate is usually adjusted automatically, and most people consider this more comfortable than the mechanical timing of the Auto SV. The default rate of the Resmed ASV is 15 BPM. It is clearly able to match your prescription exactly. From the manual:

ASV mode
In ASV mode, the expiratory positive airway pressure (EPAP) is fixed and can be manually adjusted
to eliminate obstructive events. The Pressure Support (PS) varies between the Min PS and the Max
PS to answer to the patient's need. Mandatory breaths are delivered at the patient’s recent
spontaneous breath rate, ie, the timed backup rate is automatically calculated to match the patient’s
needs and is applied appropriately in the case of an event.
ASVAuto mode
In addition to the functionality of the ASV mode, the device in ASVAuto mode automatically adjusts
the expiratory pressure in order to provide only the amount of pressure (EPAP) required to maintain
upper airway patency. The device analyzes the state of the patient’s upper airway on a
breath-by-breath basis and delivers expiratory pressure within the allowed range (Min EPAP and
Max EPAP) according to the degree of obstruction. EPAP is automatically adjusted depending on
three parameters: inspiratory flow limitation, snore, and obstructive apnea.

Backup rate
The AirCurve 10 ASV device uses breath phase mapping to provide a timed backup rate that is
synchronized with the patient’s own breathing. When the patient deviates from the ventilatory
target, the ASV device aims to stabilize the patient by adjusting Pressure Support. If necessary, it
will adjust the timed backup rate from one that matches the patient’s own recent rate towards the
built-in default 15 BPM backup rate.

[GrumpyHere]

The default backup rate of 15 is a long way from the 9 that is effective for me, or the 11 that my sister uses. 

The 15 BPM does not even come into play unless the ResMed machine is unable to restore normal breathing.

When the patient deviates from the ventilatory target, the ASV/CS PaceWave device aims to stabilize the patient by adjusting Pressure Support. If necessary, it will adjust the timed backup rate from one that matches the patient’s own recent rate towards the built-in default 15 BPM backup rate.

I am not sure why you're manually setting this parameter and so focused on it.
Your BPM is going to vary throughout the night depending on sleep stage.

ResMed reasoned that matching your RR rather than forcing a fixed rate on you would feel more comfortable.

PR must feels the same because they also provide an Auto option for BPM.

From the provider guide for the DreamStation BiPAP autoSV:

This screen allows you to modify the Breaths Per Minute setting. The Breaths Per Minute setting is a back-up breath rate where there is a machine-triggered breath to the patient within the defined timeframe per breath.  You can choose between Off, Auto, or 4 through 30. This setting only displays if PS max is greater than zero.

[GrumpyHere]

The Auto option for PR machines covers the range of 8 - 15 BPM (page 40)

http://www.masm.wildapricot.org/resource...Morgan.pdf

How ASV works (differently) on both machines are described starting from page 30.

Logically, monitoring minute ventilation should be more effective for treatment rather than monitoring peak flow. The pdf author shows that peak flow can be the same while having reduced minute ventilation.

Both algorithms are effective in treating central apneas.
PR machines respond slower because they use a 4-minute moving average, while ResMed uses a 3-minute window.

[racprops]

I am very glad to see this tread, I too found I could not get along with ResMed's 10 ASV.

I was blasted for complaining about ResMed systems on some boards.

[Solicitation For A Prescription Required Item Removed]

Thanks.

Rich

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