In need of educational material on ResMed Vauto

[JimW159]

Can anyone refer me to good educational material on the workings of the ResMed AirCurve 10 Vauto? What I hope to find is something that will help me translate the terms used in the clinical manual and better grasp the operational rationale. If not a single source, perhaps a few that can be digested somewhat easily. Your suggestions are welcome.

[palerider]

Can anyone refer me to good educational material on the workings of the ResMed AirCurve 10 Vauto? What I hope to find is something that will help me translate the terms used in the clinical manual and better grasp the operational rationale. If not a single source, perhaps a few that can be digested somewhat easily. Your suggestions are welcome.

I've never seen such a thing...(unless you want to dig through patent documents). I've taken apart S9 machines, and the 10's are similar, just shaped differently. What questions do you have?

Inside of a S9: https://imgur.com/a/S0ojG

[JimW159]

What questions do you have?

My initial concern has to do with what certain setup terms mean and what implications do they carry with them.
Initial setup of AirCurve 10 Vauto has Vauto set as therapy type with a pressure range of 12-18
The terms in setup such as "Min EPAP, Max IPAP and pressure support in VAuto mode" are also somewhat confusing:
My understanding is PS is the difference between these two values - thus, PS would = 6.0 (yet, nowhere have I seen this to be indicated or suggested. The only illustration in the clinical manual would seem to indicate PS is equal to whatever EPR would be set at in the AutoSet or CPAP mode) Which of these readings is correct? My understanding is that Min EPAP = the resultant pressure when PS is subtracted from EPAP and Max IPAP is equal to the pressure established as the upper limit of the pressure range (in this case: 18)
The next area of confusion is: Triggering and cycling in VAuto. In the clinical manual (pages 5 & 6) illustrations are provided to establish the various choices involved in setup. However, little is given by way of rationale and implications of the choices. Included in this section is a chart of Ti Max/Ti Min values but relies on additional information related to breating pattern and rate. How best to establich initial value?

I hope my confusion is not being carried forward to infect the quality of your understanding.

[palerider]

What questions do you have?

My initial concern has to do with what certain setup terms mean and what implications do they carry with them.
Initial setup of AirCurve 10 Vauto has Vauto set as therapy type with a pressure range of 12-18
The terms in setup such as "Min EPAP, Max IPAP and pressure support in VAuto mode" are also somewhat confusing:
My understanding is PS is the difference between these two values - thus, PS would = 6.0 (yet, nowhere have I seen this to be indicated or suggested. The only illustration in the clinical manual would seem to indicate PS is equal to whatever EPR would be set at in the AutoSet or CPAP mode) Which of these readings is correct? My understanding is that Min EPAP = the resultant pressure when PS is subtracted from EPAP and Max IPAP is equal to the pressure established as the upper limit of the pressure range (in this case: 18)

I'm sure that you'll still have questions, and that's fine, just ask them, and I'll respond, and eventually, we'll get all this hammered out for you

Ok. Let's start with background... PS is the same thing as EPR.. only *backwards*. EPR is a pressure *drop*, PS is a pressure rise. PS is the difference between EPAP and IPAP on any individual breath, you are correct in that.

Your example of a pressure range implies that pressure would vary between 12 and 18, this is different than a bilevel pressure of 18/12, which would be 12 on exhale, and 18 on inhale, giving that PS of 6.... however, that's when you're in S mode, (bilevel CPAP mode), not vauto mode (bilevel autoset mode). Now, with your example, (which isn't a complete bilevel setting), you'd need to determine a PS... you could, for instance, use MinEPAP 12, MaxIPAP 18, and PS 3, which would mean that the pressure could range from 15/12 up to 18/15. This would be the same as an autoset that was set at min 15, max 18, EPR 3.

My settings for instance, are MinEPAP 12, maxIPAP 25, and PS 6. I rarely see ipap above 20, but, *shrugs* there's no reason to lower the max.

If you're in S mode, you just set the epap and ipap directly, if you're in vauto mode, you set the minimum lowest pressure on exhale, the maximum highest pressure on inhale, giving you a potentially wide range that the machine can vary pressure... then you set the pressure changes for each breath with the PS.

The next area of confusion is: Triggering and cycling in VAuto. In the clinical manual (pages 5 & 6) illustrations are provided to establish the various choices involved in setup. However, little is given by way of rationale and implications of the choices. Included in this section is a chart of Ti Max/Ti Min values but relies on additional information related to breating pattern and rate. How best to establich initial value?

I hope my confusion is not being carried forward to infect the quality of your understanding.

Just in case you're not clear... trigger is how sensitive the machine is to your starting an inhalation, which is what "triggers" the switch to the higher pressure of IPAP... cycle is how sensitive it is to your ending your inhalation, and thus "cycles" back to the lower pressure of EPAP. For *most* people... there's no reason to set those at anything other than the default medium setting. Now, if you've got some kinds of lung conditions, then it can be advantageous to change those.

I changed my trigger, because sometimes before an apnea, I'd see tiny breaths, and no response from the machine, like my airway had closed most of the way... and those choked off attempts at inhaling weren't enough to get the machine to switch to IPAP... so I set trigger to very sensitive, and my AHI went down... I'm not advocating this for anybody else, unless maybe they see the same kind of aborted inhalations before apneas.

The other settings are TiMin, and TiMax, which are the minimum time the machine stays at IPAP, and the time it stays there... again, usually, absent lung conditions, there's normally no reason to change those from the default, though, again, I changed my TiMax...since I saw on SH that my inspiration time was being cut off at 2 seconds a lot of the time (the default), and apparently, my sleeping self wanted to take longer breaths... so I raised the TiMax so that my inhalations weren't being cut off prematurely.

As I said, I'm sure that this has raised more questions... so, lemme have 'em

[Pugsy]

Have you seen this?
https://www.resmed.com/us/dam/documents ... er_eng.pdf
Page 23 starts with the AirCurve stuff

I never could find a document that explains what or why to set PS at so and so.
All I could find was that for the most part it was a comfort thing unless special situations or lung issues were involved and 4 to 5 were the most common PS settings used for the bulk of the users unless someone had special respiratory needs.

[Holden4th]

Two points from PRs previous post. He mentioned the trigger setting in a different thread and I decided to investigate to see if this also worked for me. I changed mine to 'very sensitive' and it certainly did though it may not work for others.

I also raised my Ti Max from the default 2.0 to 2.4 because I felt the machine was trying to make me exhale too early. This also worked well though I realise that the machine doesn't breathe for me but encourages a change between inhaling and exhaling. The two combined gave me a better response to when I should inhale and exhale. I probably haven't explained it very well.

[palerider]

The two combined gave me a better response to when I should inhale and exhale.

It's important to make clear that the VAUTO mode just follows your breathing, you breathe whenever and however you want, and if you don't have lung conditions, like COPD, then it shouldn't get in the way at all... ie, it shouldn't be trying to get you to inhale longer than you want, or cutting off pressure before you're done inhaling.

The only reason that I'm saying this is that so many newbies get the idea that they're supposed to try and alter their breathing to suit the machine... and that's not good, the machine should follow them.

[Wulfman...]

Jim,

See if there's any helpful information in these links:

https://www.oxystore.it/Brochures/37826 ... ow_eng.pdf

http://www.masm.wildapricot.org/resourc ... Morgan.pdf


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