Need urgent help with prescription conversion

[ebitansky]

Hello all,
I have the RESMED s9 vpap adapt (ASV) that unfortunately I did not adapt well to.
Two days ago I had a new study to see whether we could find a better way to work.
Results were fantastic and a prescription was written to the following machine:
RESMED S10 BiPap S/T RR10 (backup rate)
IPAP 10
EPAP 6

The problem:
I have a back surgery tomorrow, I was asked to bring my machine with me but since it all happened so fast, all I have is my S9 VPAP Adapt ASV

There is no way I could get that new prescription BiPap

Is there anyone who could help me convert this new prescription to my old machine ? (I know how to access all of the parameters)

If this is not possible let me know as well, at least I will tell the hospital staff where I stand.

Thanks for any help or advice

[DeepBreathing]

Unfortunately there is no way to exactly replicate this prescription on the VPAP Adapt as the Adapt doesn't have a straight bilevel mode. You can get reasonably close with the following settings:

Mode: ASV. (Not ASVAuto)
EPAP: 6
Min PS: 4
Max PS: 9

This will give an IPAP varying between 10 and 15. MaxPS must be at least 5 above MinPS, which might be a problem, but it's as close as you can go with this machine. You can't adjust the backup rate - the machine will provide a backup based on your preceding minute ventilation.

An alternative approach would be to go into CPAP mode, set the pressure equal to your IPAP and set EPR to 3. This will give a pressure regime similar to your prescription. However I don't believe the machine can institute any sort of backup in this mode, which might be a deal breaker in your current situation.

[Sleeprider]

Hello all,
I have the RESMED s9 vpap adapt (ASV) that unfortunately I did not adapt well to.
Two days ago I had a new study to see whether we could find a better way to work.
Results were fantastic and a prescription was written to the following machine:
RESMED S10 BiPap S/T RR10 (backup rate)
IPAP 10
EPAP 6

As far as I know, the machine you describe does not exist. BiPAP is a proprietary name for the Respironics bilevel. The Philips Respironics BiPAP S/T is currently available in the System One 60 Series (model 1060).

The Resmed version of this is the Aircurve 10 VPAP ST.

In both PRS1 and Resmed, the ST Mode will initiate a breath and automatically starts IPAP. When IPAP starts, the machine controls the duration of IPAP and automatically lowers pressure to EPAP within a set time.

Your current ASV does not have the spontaneous timed mode of operation, but I'll agree that the next best setup would be to fix IPAP and EPAP pressures of 10/6 (PS=4). So if the PS is set to minimum of 4 and maximum of 4, the machine should trigger IPAP when you fail to take a breath, and will hold the 4.0 pressure support, rather than the much higher ASV support. S/T is often prescribed to people with COPD and obesity related hypoventilation, but is not ideal for those that have central or complex apnea. It assists in breathing with a timed backup rate that will initiate IPAP, but does not act as a servo ventilator.

[DeepBreathing]

The Resmed version of this is the Aircurve 10 VPAP ST.

Actually that name doesn't exist either, as far as I know. (However Resmed seems incapable of maintaining a constant naming convention any more, so there may well be an Aircurve VPAP). I believe it's the AirCurve 10 ST which is being referred to. http://www.resmed.com/us/en/commercial-p...10-st.html I assume the term "bipap" was used in its generic sense to mean a bilevel machine (notwithstanding that Philips may have a patent on the name).

So if the PS is set to minimum of 4 and maximum of 4...

Unfortunately for this purpose, the S9 VPAP Adapt does not allow the min and max PS to be set to the same number. PSmax must be equal or greater than PSmin + 5. We don't know why the OP is changing from an ASV to an ST, so the variable pressure support may be a problem for him. However the settings in my earlier post are about as close as you can get to his prescription with the VPAP Adapt.

[Sleeprider]

DB, of all the machines out there, the ones I have least familiarity with are S/T. Thanks for your corrections. I think until the recent release of the Sleepyhead 1.0 beta, we couldn't even see data from these machines. Without more insight on why this prescription was issued, it's hard to judge the likelihood of success. I'm pretty sure the O.P will be using his machine for post-surgery support, and that he will be under an anesthesiologists care during the operation. Probably no problem in using his ASV until the replacement is in place. We don't even know how his current machine is setup other than min and max EPAP, and I don't think any data has been posted regarding the type of events that are making up his currently high AHI.

[DeepBreathing]

Ebitansky, let us know how you got on... And good luck with the surgery!

[srlevine1]

Might I suggest that you call the hospital and discuss this with their respiratory technician. When I was hospitalized for two days of advanced cardiac diagnostics, the hospital supplied the machine and it was set per my doctor's orders.