New machine - arghh

[Johnboy]

If you have followed my recent thread you will know that I have been provided with a new bilevel NIV machine, the Lowenstein Prisma Vent 40. I was anticipating this to be a relatively easy switch over as I found getting used to the Dreamstation really easy - boy was I wrong. 

The new machine is set at 16 (same as Dreamstation) and 6. The nurses spent some time with me calibrating the machine and I went to bed hoping for great results. After 2 hours treatment I couldn’t stick it any longer and switched back to the Dreamstation. The pressure on the inhale was extraordinary and felt like it was trying to rip the mask from my face. Further it was not corresponding with my respiratory rate which just felt weird. The nurses had tried to set this up but stated they couldn’t go any lower as this would be tantamount to hypo ventilating (set at 10). This makes you feel like the machine stops the breath before  you normally would.

As the Dreamstation was treating my hypopneas well but was failing on the RERAs should I stay with this or give the new machine more time?

I can’t post graphs etc as this is not Oscar supported. Also bizarrely I can’t get AHI readings etc as the technician told me they are not available. I was told that the only measurement of efficacy was how I felt  Leaves me wondering if this just a duff machine.

Any advice welcomed.

John

[SarcasticDave94]

It sounds a bit like a timing issue, and the fact that in my research the Prisma Vent 40 appears to be an NIV ventilator. It's not going to feel like, or compare to, the DreamStation because it's not in the same machine class.

My suggestion would be to get another pressure setting session and get them to see if they'll adjust things to make you more comfortable. I don't know why they're justifying putting you on this type of machine, but there's likely a reason that's valid. Any other respiratory illness, disease they're treating? Of course it could be a big mistake and they're over treating you. Have you asked why this vent 40 was chosen? But even so, I'd not go back to the DreamStation.

[Gideon]

Ask if a BiLevel such as the VAuto would do the same. If I understand the settings they took you from a PS of zero on the DS to a PS of 6. Is there a backup rate involved?

Ask for the detailed flow rate charts so you can perform your own evaluation.

Unless there is something going on Insist on something that you can get data on, PR machines are a poor choice for treating RERAs.

[Sleeprider]

This machine is a bilevel ST appropriate for pulmonary disease and impairment like COPD and neuromuscular disorders. What are you treating, and what are the settings for IPAP, EPAP , mode, breath rate, rise time? Your prior machine was an auto CPAP and you apparently have no problems with spontaneous respiration, although your tidal volume is nothing to brag about. What is going on that lead to the use of this ventilator?

[Johnboy]

Thanks for the responses. I have no pulmonary or respiratory disease and have very robust sats. This treatment is supposed to only address the RERAs I am experiencing (it is also very evident that they have no idea what RERAs are and anything beyond hypoponeas is outside their comfort zone and moved to a different class). When I asked why this machine they stated that this is the only Bipap-Bilevel machine they provide. The NHS contract for suppliers to provide specific machines and not a range of machines and/or services.

Unless they can make it more comfortable I can’t see me using it long term. Whilst no expert I am certain I am being over treated a point which I made to them.

John