Help with a new BI-PAP
Hi,
My wife has used her CPAP (resmed 11) for over 2 years. Her favorite mask is the FP Vitera and her max pressure was 16.
She is now in ICU (finally received proper healthcare after asking for 2 years!) and they finalized her new therapy plan. She will be on a BI-PAP + O2 from now on. Her max pressure is now 30 and the BI-PAP swings between 14 and 30 cm on average.
The thing is, we now have all problems getting the mask to seal and to remain sealed for more than minutes. We successfully did it with the CPAP and 16 cm but have not much success these last days.
We also confirmed the Resmed F20 can not fit her. The strap on the top of the head is not deep enough. Consequence is the mask will always be pulled upward.
Any trick, info, suggestion for our situation ?
Thanks in advance,
RE: Help with a new BI-PAP
Hello Heracles - I believe there are masks designed especially for high pressure (20+cmH20) but don't have any specific model recommendations. You also may try mask liners for a better seal or perhaps experiment with Resmed's "Airtouch" line where the masks come lined in a felt like material that seals well. I've used Airtouch up to just over 20cmH20 myself. Good luck and I hope your wife recovers well.
RE: Help with a new BI-PAP
I used the Vitera with the ASV at IPAP 25. If adjusted and fit correctly, the Vitera should be OK.
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RE: Help with a new BI-PAP
I have used Vitera and Quattro FX at IPAP between 20 and maybe a little over that.
The Vitera doesn't have to be so tight, but my FX does.
When I wake up being blown out by my mask, I either quickly readjust my mask. Usually upward; but can be down or to either side until leak improves.
I have small pieces of cloth (glasses cleaner cloths) I sometimes wedge into the hole where the most air is coming out to try to do a quick stop-gap plug of the leak.
And if all else fails, what has worked is turning machine off, then restarting (so machine starts at lower pressure(s)).
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RE: Help with a new BI-PAP
Thanks to all of you.
My wife will be discharged from the ICU tomorrow. Government's program will provide her with a Vivo 3 as BI-PAP and the respiratory therapist that showed it to us took a few masks with her for my wife to try. It was a hole-in-one : The Philips Amara View.
In the past, with her CPAP, she tried the N30 and it was a terrible fail. Her pressure was too high already (16). When working to identify her BI-PAP therapy plan, she tried the F30. It was another fail. She fell all the pressure directly pushed in her nostrils and could not endure it. Not sure why it feel more diffuse with the Amara View but hey... The important is that it works and is comfortable.
One major difference with the VIVO is the way it reports leakage. A vented mask properly sealed will be marked with 0 leakage by a Resmed device like the Astral or her old CPAP. Still, masks are vented and a significant volume is leaking the circuit by design. Resmed does not count these "expected-by-design" leakage and counts only the unexpected ones. The Vivo returns the absolute amount of leakage, expected or not. As such, her "perfectly" sealed mask leaks at around 45 and the RT said that leakage below 60 is good.
