S9 Climate Control & ResMed VP responds to Apnea Board member questions

[SuperSleeper]

Strange that you were given the heated humidifier without the Climate Line hose. Check your Slimline, if indeed it is not a Climate Line. The Climate Line has a bright orange stripe on the end piece and a bright orange bayonet catch which latches into a socket on the humidifier. If your Slimline hose is not a Climate Line, I suggest you get one, as it will simplify the whole humidification business for you!

[SuperSleeper]

From what the RT said, the H5i heated humidifier "comes with" the S9 Autoset device. All the ResMed printed materials show the ClimateLine as "optional," & the RT said I could use the standard tubing that I had with my previous unit. The SlimLine that comes with the unit seems really stiff & has a much narrower inner diameter.

After 2 weeks of trying to figure out how to operate the device, it turns out I shouldn't even have/can't even use the Autoset because it's designed to be compatible with UP TO 4L/min of supplemental oxygen ......& I use more than their maximum.

All CPAPs (EXCEPT the Autoset) accept up to 15L/min. of supplemental oxygen...........so the Autoset is the only CPAP I should NOT have...........but it's the one the RT gave me. Go figure.

[SuperSleeper]

All CPAPs (EXCEPT the Autoset) accept up to 15L/min. of supplemental oxygen...........so the Autoset is the only CPAP I should NOT have...........but it's the one the RT gave me. Go figure.

I wonder why , the S9 Autoset can be used in either Autoset or CPAP mode .

(The SlimLine that comes with the unit seems really stiff & has a much narrower inner diameter.)
http://www.s9morecomfort.com/s9morecomfo...-tube.html

[SuperSleeper]

I clicked on the link, & saw tubing that looks like my "standard" tubing; the SlimLine that came with the device is yellowish/white stiff, plastic.

I also saw that Autoset can also be run in CPAP mode....BUT.............

I got the Clinician Manual that describes all the models in the S9 Series, & sets the "maximum allowable supplemental oxygen flow" at 4L/min.

My DME supplier is the one who told me that CPAPs allow 15L/min. except the Autoset..........although ResMed Tech Support confirmed the 4L limit to me & to my Medicare Advantage RT. I don't need 15........but I sure need more than 4, so it's been a very expensive lesson.

[SuperSleeper]

It is obvious that your DME has the "duty of care" to supply you with the right equipment! You must have recourse with this company, if you persist! As far as the Climateline is concerned, the DME is able to package this with your H5i but chose not to do so for the sake of a few bucks. I also get zonk's point that in cpap mode the S9 should have the same O2 capacity as other cpaps.

[SuperSleeper]

As far as the Climateline is concerned, the DME is able to package this with your H5i but chose not to do so for the sake of a few bucks.

I agree that the climate line and the cleanable water tub are essentials and should be included and not sold separately as an optional extras .

[SuperSleeper]

Glad I'm not alone in my.............naivete; I DID hope that by posting in THIS thread, I might get a comment from the ResMed V.P................but, no.

I told my RT that I'm going back to my 1st CPAP device & he suggested a night oximetry test at my current 9L/min supplemental oxygen.....even tho' he talked to ResMed & they told him 4L/min. is the maximum allowable. He figured we could then do a 2nd night with the oxygen at 4 (per ResMed rules) & compare results. I suggested we should also do a 3rd night with my 1st device & 9L/min supplemental oxygen to see if what I already have is better FOR ME than this S9 Autoset (because what good does comparing 2 settings on the same device (S9 Autoset) really accomplish?)

So surprising that the results (according to the SD card I took out of the S9 & gave to the RT when I returned the oximeter) on the 2nd night (Autoset at "legal" 4L/min supplemental oxygen) were the best of the 3 nights: 94% oxygen saturation, no apneas, & pressure went from 10.5 to 15, with average of 13. On all 3 nights, my heart rate was between 55 and 60 beats per minute. I didn't like that heart rate; read online that 60 bpm is bradycardia, so I e-mailed my Primary Care doctor & he says that even down to 40 bpm is a great heart rate(?) We ARE in Denver, but still.........

Then I had to meet with the RT so he & I could look at all the settings & change what we needed to change. That's where the knowledge I've gained on this Board & info I've seen in Clinician Manual I got from this Board came in handy:

----- I made sure that the mask setting was Mirage Ultra......he'd selected "nasal."
----- I made sure that the the minimum pressure didn't stay at 4; we changed it to 8 because I don't seem to drop down that low, but just in case.
----- I made sure RT "Ramp" setting matched mine (which says "off.") RT says it doesn't matter; Patient settings override RTs anyhow..........but I made him do it. Not that I don't trust him, but I don't trust him.
----- I made sure EPR was not turned "Off"---the way it was. We put it at "Full time" & at "3" (there are 2 settings.

I asked RT how much water to add to humidifier; he admitted he doesn't know: just fill it to the "Maximum" line, but he doesn't know how much that is (but it's in "Welcome" book as 380 mL & in Clinician Manual as 380mL/12.5 fluid ounces). I gave him the info to spare other patients the guesswork.....& ResMed should buy a clue.

I couldn't convince RT that the HEATED humidifier needs to be pre-heated, tho; he insists that you can turn on the "warming Up" function & then start treatment immediately. He says I can keep doing it MY WAY, but it's not necessary to pre-heat. I told him to call ResMed.......because I have.

Bottom line: I'm not going to use the H5i humidifier at all. The tubing doesn't need to connect to the device thro the back of the H5i humidifier; there's a place (illustrated in photo in "Welcome" manual) on the side of the S9 itself where you can plug in the tubing. The H5i is only an "option" (like ClimateLine) anyhow.

I still don't like that the plug on the electrical cord isn't polarized because it falls out of my electrical outlet. ResMed says I can try pushing the prongs on the plug further apart (?)

So......I'll be trying the S9 again.

[SuperSleeper]

There were numerous discussion about the climate line whether it is safe to cover it with a tube wrap or sleeve and the verdict is still out . ResMed and Fisher & Paykel recommend not to place the heated tube under the bed covers and for best humidity performance to place it on top of the bed covers . At the time ResMed say that the tube wrap can be used with the climate line with this warning :
Do not use the tubing wrap if the room temperature is above 86F (30C). At higher temperatures the air temperature at the mask may be too hot.
It seem confusing what is the point of having a heated tube if you still have to cover it (or the suggestion) to protect against rainout !

[SuperSleeper]

I fill the water chamber just below the top marker (the higher humidifier setting the more water would be used) and pre-heat the water before starting treatment as my nose like it this way , it takes about 20 mins but you can start treatment anytime . If you are not using the climate control or humidifier than you can use the slim line (or the standard tube as long as you adjust the setting to standard in lieu of slim line) .

[dbrew4]

I'm having some issues with my machine. Here are is my CPAP Profile
Machine: Resmed S9 Elite
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro
Humidifier: H5i/ClimateLine
CPAP Pressure: 6
CPAP Reporting Software:SleepyHead
Sex: Male
Mouth Breather...always have...always will

I just started using this machine about two weeks ago. Prior to that I had been using a S8 Elite II with a H4 humidifier and because of rainout issues, I purchased a after market heated tube system (HYBERNITE RAINOUT CONTROL SYSTEM). I've had no issues with my old system. Since I have been using my S9 system I have had a dry mouth and stuffy nose. I understand that if I disable the Climate Control System, which controls the absolute humidity, I can manually adjust the humidity but rainout becomes a issue. Any thoughts on this issue? Maybe this post can be forwarded to "Gil Ben-Dov" from Resmed for input if needed. Tks