[Treatment] Need help interpreting Oscar data

[Sleeprider]

Here is the recommended titration protocol from Resmed. You can see they Suggest EPAP 5.0, PS min 4.0, PS max 20. One good reason for using higher EPAP is that this represents your "positive end expiatory pressure" (PEEP) and is a major factor in recruiting lung volume and improving oxygenation.   I recommend you read this reference material starting at page 34 to 38. https://document.resmed.com/en-us/docume...er_eng.pdf I'm sure you will have questions after reading.

[Jay51]

I am sorry I missed your question last night about PS min.  Sleeprider is right (again).  Set EPAP at 5.  I suggested 3 or 4 just to be ultra conservative and your ST mode used 3.  5 will work better.  EPAP is the lowest pressure the machine gets to.  It helps "stent" or "splint" the airway open for breathing.  

PS 4 min should be fine.  Max PS of 20 is what they recommend, but if you start getting jolts of air during the night that make it impossible for you to sleep, just lower PS max to 10.  EPAP pressure (5) + PS (the range of 4 to 20) = IPAP.  IPAP is the maximum pressure that the machine gets to as you are inhaling.  It gives a little boost as you inhale to help overcome any of the multiple forms of resistance that can impede inhalation.  

[/url]https://ivapscalculator.resmed.com

[url=https://www.bing.com/ck/a?!&&p=13fb6578bb4f1408JmltdHM9MTcwMDE3OTIwMCZpZ3VpZD0zNjM2YWJmOC1hZTk0LTZiNTktMjkwMC1hNGY4YWY2ODZhMmUmaW5zaWQ9NTE4Ng&ptn=3&ver=2&hsh=3&fclid=3636abf8-ae94-6b59-2900-a4f8af686a2e&psq=ivaps+calculator&u=a1aHR0cHM6Ly9pdmFwc2NhbGN1bGF0b3IucmVzbWVkLmNvbS8&ntb=1]This is a link to the online IVAPS calculator.   As you change different variables, it recalculates and gives new values.  The main value it calculates is the Target VA in L/Min.  I got your number of 4.6 here. 

*Another important value here is the minute ventilation number.  Yours was 5.75 in your OSCAR charts.  You can tolerate this number, but it needs to be a bit higher since you think co2 is building up in your lungs.  If you ever experiment here and change values to see what happens, try to get this number probably from 5.75 to maybe in the 6's.  7.0 or higher may be too much for you.  But maybe not.  Try not to let this number get below at least 5.0 either.  

Please feel free to ask any other questions.  Hopefully you have enough information and numbers to try IVAPS tonight.  If it feels off or too powerful, just lower the values.

[OldPolioLady]

Sorry I have been busy with pre Thanksgiving activities. I have spoken to a Polio friend who is on the Trilogy. She told me that her machine is set to Assist-Control not AVAPS. Then I remembered that my current pulmonologist said she would put the Trilogy on Assist-Control too. She also told me what my Tidal Volume and MV should be. I just have to find time to locate those values in my medical records. I want to check those values against what the IVAPS values will be set to before I use it.

[OldPolioLady]

I think my biPAP machine is broken. I tried to change the iVAPS settings and I had no air coming out of the machine. Then I switched back to ST mode and all I got was air (VT over 1,000) with no cycling. It’s 6 years old. Calling my pulmonologist tomorrow.

[Jay51]

I am very sorry to hear that.  With a 6 year old machine, it may need to be repaired/replaced.