Resmed bipap ST settings question

[Moemah123]

Hi everyone,

I wanted to ask about some of the settings for BIPAP ST. Noticed that my spt trigger is at 77 percent and cycle is at 99.5. My question is my goal to make those numbers as high as possible? My pressure settings is 14/9 with back up rate of 10. TI MAX is 4 and ti min is 0.3 and rise time is min , trigger med and cycle med.

So couple of things I don't understand

1. Do I need trigger and cycle to be close to 100 if yes what can I do to above settings? E.g increase or decrease sensitivity 

2. I see RR as 12 any idea whats that?

3. Ti as 1 second not sure how that ties with above max and min Ti and if they sound reasonable

Lastly I:E as 1:3.6

Appreciate all the help in setting expectations on settings

[Sleeprider]

Your results are about as expected. Spontaneous cycle is less important, and simply means your time of inspiration (Ti Max) was exceeded and the machine cycled to EPAP. You could easily make spontaneous cycle 100% by making Ti Max longer, but 99.5% is not a problem at all. The 77% trigger is a bit harder, and is a reflection of the central apnea events you know about. When your full respiration cycle exceeds 6-seconds, the machine will trigger IPAP. This is a function of the backup rate, and with your median respiration rate of about 13.4 bpm,the backup rate of 10, is exactly what it should be. Keep in mind, that is only a 4-second margin until an apnea would be flagged (10-seconds). Something to consider doing is to check the duration of the UA events on that night you turned off the ST mode. If all the events are minimal duration of 10-15 seconds then they are minor events, but if they were going well over 20 seconds, that is why you need the backup rate, and will always have less than 100% spontaneous trigger.

[Moemah123]

Your results are about as expected.  Spontaneous cycle is less important, and simply means your time of inspiration (Ti Max) was exceeded and the machine cycled to EPAP. You could easily make spontaneous cycle 100% by making Ti Max longer, but 99.5% is not a problem at all.   The 77% trigger is a bit harder, and is a reflection of the central apnea events you know about.  When your full respiration cycle exceeds 6-seconds, the machine will trigger IPAP.  This is a function of the backup rate, and with your median respiration rate of about 13.4 bpm,the backup rate of 10, is exactly what it should be.  Keep in mind, that is only a 4-second margin until an apnea would be flagged (10-seconds).  Something to consider doing is to check the duration of the UA events on that night you turned off the ST mode.  If all the events are minimal duration of 10-15 seconds then they are minor events, but if they were going well over 20 seconds, that is why you need the backup rate, and will always have less than 100% spontaneous trigger.

Thanks Sleeprider, I have another question. I was able to get my hand on ASV device (750) 352 hours. I wanted to try it out. How does my settings translate to ASV to have a fair comparison like pressure min max settings etc, is there a link on forums as well if this question has been asked before. As you know my settings are 14/9 so far.

Thanks again!

[Sleeprider]

ASV is a whole different beast. Default settings for complex apnea are ASV Auto mode, EPAP min 5.0, EPAP max 15.0, PS Min 3.0, PS max 15.0.  I'm going to assume the Resmed Aircurve 10 ASV.  For you, I would start just a bit higher with EPAP min 7.0 EPAP max 10.0, PS min 3.0, PS max 15.0.  The ASV automatically detects and maintains your respiration rate in BPM and minute vent in L/min.  It will automatically increase EPAP pressure for obstruction, and use pressure support as and when needed for hypopnea and central apnea.  I suspect we will reduce PS max after we see how it responds and how you feel. If you need more EPAP pressure or pressure support to be comfortable, we will make adjustment after the first trial Nice find.

[Sleeprider]

FYI Titration Protocol for ASV

[Moemah123]

FYI Titration Protocol for ASV

Will give it a read, I have a week before device arrives so hopefully enough time. Will circle back ! 

Thanks