RE: In anticipation of my BIPAP Re: New Thread

[Plmnb]

Hi Sleeprider and all.

Finally received my ST-A today.

What should all the settings be in your opinion?  The RT set it to what the dr. said I'm pretty sure you will have another idea of what they should start at.

I NEED to take a nap now and this would be a good time to experiment don't you think?

Regards,

[slowriter]

I think you want to reread this post, which should have most of the info.

http://www.apneaboard.com/forums/Thread-...#pid334011

[Plmnb]

Thank you slowriter.  I printed it out but it is a bit confusing for me.  Especially with the last couple of posts that Sleeprider made.  I'll try to make sense of it until I hear otherwise.

Regards,
Plmnb

[Geer1]

What mode is it in? If in iVAPS mode what is the target ventilation? These are the most critical settings and weren't mentioned earlier.

Probably best to flip through the settings and type them all in here so can tell how things are currently set and what changes if any are recommended.

[slowriter]

Thank you slowriter.  I printed it out but it is a bit confusing for me.  Especially with the last couple of posts that Sleeprider made.  I'll try to make sense of it until I hear otherwise.

Regards,
Plmnb

I don't have any experience with these machines, myself, but let's what at what he wrote:

I suspect EPAP will be set between 10 and 14 cm, but if you have any information on lower pressure we can review it. Other settings should follow the protocol, i.e. Min PS 4.0, Max PS 20.0, Target Va based on height.  I think I recall your normal tidal volume being between 460 and 500 mL.

So you want iVAPS mode, and you've got the default PS min and max there, 

He's then suggesting min EPAP between 10-14; maybe just use your judgment (unless he weighs in again)?

The rest is where it gets fuzzy for me. Sounds like you need to set your height; not sure what else. Maybe do what you can with this and if questions report back?

[Plmnb]

It is set as follows:

Therapy

Mode T
IPAP 20
EPAP 6.0
Resp Rate 12
Ti 1.0s
Rise Time Min
Mask Full Face


Comfort

Ramp Time Off
Ramp Down Off
Humidity 4

And a ton of alarms on off which is fine by me.

Options

Essentials Plus
Confirm Stop Off
SmartStart Off
Therapy LED Off

[slowriter]

Or actually, the box in that titration guide he posted (again, this is for the iVAPS mode he's recommended) is pretty straightforward, with my comments in brackets.

• Set Patient Height (eg, 70 inches for 5’10”)
• Set Target Pt Rate equivalent to patient’s spontaneous respiratory rate
(recommended no less than 15 bpm) [you can set this based on your RR on the VAuto?]
• Set Target Va such that Vt is equal to 6ml/kg IBW [I think this why SR mentioned you TV]
• EPAP = 5 cm H2O [for you, maybe 10?]
• Min PS = 4 cm H2O
• Max PS = 20 cm H2O

[Plmnb]

Ok, so far

Changed machine to:
 Ivaps

Height 64 inches (I’m actually 52 3/4 but you can’t set that.  Didn’t know if I should lower or raise this string).

Target PT rate: 1.5 (Not sure should stay at this)?

Target Va 6.0L/min

EPAP 7

Min PS 4.0

Ti max 2.7 max

Ti Min 0.3

Rise Time Min

Trigger Med

Cycle Med

Then there is a Learn targets I haven’t messed with.

[jaswilliams]

It looks like the machine is currently set in T mode that’s not what you want

[slowriter]

The PT rate should be somewhere around 15 or 16 (based on the guidelines, and your vauto data).