Little Larissa - please read

Banned wrote: Breath Rate (BPM): 15
Inspiratory Time (Ti): 1.8 (seconds)
Rise Time: 6 (0.6 second)

Banned, I personally haven't seen a provider's manual for AVAPS. However, 15 BPM calculates to one complete respiratory cycle every 4 seconds (both inhale and exhale). Resmed VPAP manuals would recommend that half of those 4 seconds should normally be allotted to inspiration, for a Ti Max of 2 seconds. However, Resmed would have Ti Max slightly "short-cycled" or capped on an as-needed basis for COPD (to cope with possible "breath stacking" which can pose increasingly difficult expiratory work and thus undue cardiopulmonary distress for COPD patients).

If Respironics' recommended inspiratory times concur with Resmed, then a 15 BPM setting just may warrant a slightly longer Ti than 1.8 seconds. However, you may have already methodically experimented with these parameters, only to discover that a 1.8 second inspiratory time is best for you. That 1.8 second setting (doubled for both I and E) works out to a natural or spontaneous BPM of roughly 16.67 (and latency backed-up at a slower 15 rate with your setting). And that may be just right for you based on your previous BiLevel trials.

Banned wrote:The only downside to this particular copy of the AVAPS is when you turn the machine 'on' the motor slams against the inner housing. As long as it isn't going through the housing, it should be good to go. There is also no way to get the machine out of 'Provider mode' no matter when or how long you press the 'Silence' button.

Banned, since you're an engineer I'll toss out three ideas that you probably already considered: 1) crack the housing open to make sure the motor is securely mounted, 2) use a manometer to spot check the full pressure range while in CPAP mode, and 3) inject a burst or few of compressed air under the silence button---on the off-chance that debris is impeding full switch closure. Also consider dusting if not sanitizing the entire machine while the case is open.

If the inability to exit provider mode is a function of corrupt firmware or other control-circuitry malfunction (as opposed to a faulty switch), then the machine's entire functional integrity should be questioned. IMO the machine should be considered highly suspect based on the condition you described above. So please be very careful, sir...

-SWS wrote:I personally haven't seen a provider's manual for AVAPS.

I picked up the AVAPS on Friday and promptly left for the beach house (rental) for Labor Day weekend with the Adapt SV. Got home today. Getting appropriate AVAPS documentation to you is not a problem.

-SWS wrote: 15 BPM calculates to one complete respiratory cycle every 4 seconds (both inhale and exhale). Resmed VPAP manuals would recommend that half of those 4 seconds should normally be allotted to inspiration, for a Ti Max of 2 seconds. However, Resmed would have Ti Max slightly "short-cycled" on an as-needed basis for COPD (to cope with possible "breath stacking" which can pose increasingly difficult expiratory work and thus undue cardiopulmonary distress for COPD patients).

If Respironics' recommended inspiratory times concur with Resmed, then a 15 BPM setting just may warrant a slightly longer Ti than 1.8 seconds. However, you may have already methodically experimented with these parameters, only to discover that a slightly shorter inspiratory time is best for you.

No argument that I may end up lengthening Ti 1.8 to Ti Max of 2.0 (2.0 being the self-limiting AVAPS algorithm for a corresponding 15 BPM). I took the 15 BPM from the average BPM Rescan v.3.5 data off my Adapt SV.

I reviewed dsm's Encore data that shows him with an average Vt of 650 ml. I'm using that as a baseline for where I should be. My average Vt of 500 ml has always made me feel like I was breathing a bit 'shallow' while on the Adapt SV. Hence, when you and SAG and SG started talking abouot the AVAPS, I slowly started to pay attention.

The AVAPS, as you suggest, is for Obese, COPD, and Restrictive patients. I'm experimenting that I may (or may not) be somewhat on the restrictive side. Although SAG suggests that a Vt of 500 ml would fall in the normal range, 500ml is still an average, meaning I must be breathing less than 500 mI at some points during the night. So perhaps the AVAPS will help raise my average Vt as I would like to breathe a 'little deeper' while I sleep. Besides, I'm a junkie for self-diagnosing and self-medicating with these devices.

The AVAPS literature says:
1. Set faster I-Time (Ti) for Obstructive patients to allow more E-Time.
Set slower I-Time (Ti) for Restrictive patients...up to 50% I-Time. (I don't quite understand this statement)
2. Use shorter rise time for Obstructive patients (1-4).
Use longer Rise time for Restrictive patients (3-6)

I'm assuming the timed breathe rate of the S/T AVAPS will continue mitigate my old gasping issues.

-SWS wrote:Banned, since you're an engineer I'll toss out three ideas that you probably already considered: 1) crack the housing open to make sure the motor is securely mounted, 2) use a manometer to spot check the full pressure range while in CPAP mode, and 3) inject a burst or few of compressed air under the silence button---on the off-chance that debris is impeding full switch closure. Also consider dusting if not sanitizing the entire machine while the case is open.

If the inability to exit provider mode is a function of corrupt firmware or other control-circuitry malfunction (as opposed to a faulty switch), then the machine's entire functional integrity should be questioned. IMO the machine should be considered highly suspect based on the condition you described above. So please be very careful, sir...

Thanks, and I'll be careful! I know the worst I can do is send this AVAPS back for repair or replacement. It is a Respironics product so being defective doesn't surprize me in the slightest. and I'm not sure if ReMed makes anything like it. It's not arching or billowing black smoke yet, so I will give it a go tonight.

I'll let you know if I make it through the night.

Banned

Banned wrote: The AVAPS literature says:
1. Set faster I-Time (Ti) for Obstructive patients to allow more E-Time.
Set slower I-Time (Ti) for Restrictive patients...up to 50% I-Time. (I don't quite understand this statement)
2. Use shorter rise time for Obstructive patients (1-4).
Use longer Rise time for Restrictive patients (3-6)

I looked this one up. I think clarification for the above can be found in this PDF document: http://www.cpapsupplyusa.com/community/ ... nload.aspx

So, "Set faster I-Time (Ti) for Obstructive patients to allow more E-Time" means Ti is typically set at 25% to 33% of T Total (total breath time for I & E),
and "Set slower I-Time (Ti) for Restrictive patients... " means Ti is typically set between 33% and 50% of T Total (total breath time for I & E)

So that Ti of 1.8 seconds is in range for restrictive pulmonary disorders. My understanding is that restrictive type disorders can be roughly subdivided into chest-wall type restrictive disease and lung capacity type restrictive disease (with a variety of pathologies occurring in each broad category). Additionally obesity-related hypoventilation can restrict diaphragmatic musculature effort more than contributory effort executed by chest-wall accessory muscles. If you still entertain the possibility that you just may have CSDB/CompSA then machine over ventilation may be a concern. On that basis 650 mL tidal volumes may turn out to be problematic, if they happen to over ventilate. It will be interesting to see what you discover. I think I would have taken the cautious approach of volume-assuring whatever tidal volumes VPAP ASV happened to achieve (or just a tad less), and then gradually and experimentally incrementing from there. Who am I kidding? I would have tried to find a great pulmonologist instead.

Also, I mistakenly thought you were describing a used AVAP machine when I suggested those preliminary service type steps. Looking at your post above it sounds as if you might have received a brand new defective machine. I sure hope your new machine is not problematic after all. Good luck.

Banned wrote:

rested gal wrote:

StillAnotherGuest wrote:You only need a volume solution if you have a volume problem.

SAG

Hmmm. Something about that sounds vaguely familiar...

I'll be trailing a Respironics AVAPS machine tonite.

Based on what I have learned here, I'll run my initial (self) titration tonight at:

Mode: S/T AVAPS
EPAP: 11 cmH2O
IPAP Min: 17 cmH2O
IPAP Max: 25 cmH2O
Tidal Volume (Vt): 630 ml
Breath Rate (BPM): 15
Inspiratory Time (Ti): 1.8 (seconds)
Rise Time: 6 (0.6 second)


The AVAPS appears to be an all manual set-up. No AUTO BPM. Not exactly a set-it and forget it machine. Allot more dial winging than the simple ResMED VPAP Adapt SV, so it should be right up my alley. My plan is to dial it in for comfort and check the numbers (as usual).

The only downside to this particular copy of the AVAPS is when you turn the machine 'on' the motor slams against the inner housing. As long as it isn't going through the housing, it should be good to go. There is also no way to get the machine out of 'Provider' mode no matter when or how long you press the 'Silence' button. Hey, it's a Respironics machine, but on the bright side, I can crank up the Tidal Volume and wear a Mirage Micro nasal mask with no alarms.

Banned

Banned,

Very nice to 'see' you

Just some thoughts re your lab-ratting

1) Good luck (am betting you will find the experience very good - but as always bets can be lost)
2) The 'slam' that you notice is (I believe) the air-valve outer sleeve being activated. It is fitted with a coil very similar to a loudspeaker cone.
These Bipap machines that use the air-valve flow control run the motor up to max speed (they run at a fixed speed) then when at max, they fire up the magnetic field in the air-valve outer sleeve which causes it to move very fast into position ('thump'). When the machine is off, pick up the box & gently shake it side to side & your should feel the air-valve outer slide rocking from side to side as you tilt the case.

3) SV might well still be the better choice but I am looking forward to your eval of AVAPS

4) Again, good luck & keep us posted (start an AVAPS thread)

#2-a Also am betting there is nothing wrong with accessing your clinical menus - these models can be tricky getting to those menus. I have had similar "why can't I get back to clinical menu ?" - "I did it last week ok ?". Just keep experimenting.

DSM

Photos of that Air-valve that I believe is the source of your mysterious 'thump' - as you will see it is not small but has been
the backbone of the Respironics Bipap design for some years & is a brilliant air controller. But as with all great devices, is
now too expensive to mfg so just like Resmed did, Respironics are switching to variable speed motors to replace both these
items shown. One smaller variable speed motor is much cheaper to incorporate than this particular arrangement no matter
how good it has been. Respironics just like Resmed, are learning about the whine problems that occur with using variable
speed motors (they need to accelerate very quickly, they need to spin very fast & the tips of the fans need to stay clean to
prevent noise. Resmed solved their problem by putting a fan at each end of the motor which doubled the air capacity &
allowed the motor to turn slower (thus less potential for whine) - these motors have no problem with load or torque
but when then are run at fast speeds they can create a harmonic whine as well as sonic whine. The noise problem has been
compounded by the market demand for smaller machines. The tiniest fan I ever saw is in the PB42x family. It is quite
amazing but they to had some whine issues in early models. The thing about a small fan is it has to spin faster to do the
same airflow as a larger fan.

The fixed speed blower & the airvalve (it feeds unused air back to the blower)

dsm wrote:Banned,

Very nice to 'see' you

Just some thoughts re your lab-ratting

1) Good luck (am betting you will find the experience very good - but as always bets can be lost)
2) The 'slam' that you notice is (I believe) the air-valve outer sleeve being activated. It is fitted with a coil very similar to a loudspeaker cone.
These Bipap machines that use the air-valve flow control run the motor up to max speed (they run at a fixed speed) then when at max, they fire up the magnetic field in the air-valve outer sleeve which causes it to move very fast into position ('thump'). When the machine is off, pick up the box & gently shake it side to side & your should feel the air-valve outer slide rocking from side to side as you tilt the case.

3) SV might well still be the better choice but I am looking forward to your eval of AVAPS

4) Again, good luck & keep us posted (start an AVAPS thread)

DSM

Great to hear your thoughts, DSM... I also agree that it would be nice to get a dedicated AVAPS thread going to follow Banned's experience. High hopes for Banned!

-SWS wrote:If you still entertain the possibility that you just may have CSDB/CompSA then machine over ventilation may be a concern. On that basis 650 mL tidal volumes may turn out to be problematic, if they happen to over ventilate. It will be interesting to see what you discover. I think I would have taken the cautious approach of volume-assuring whatever tidal volumes VPAP ASV happened to achieve (or just a tad less), and then gradually and experimentally incrementing from there. Who am I kidding? I would have tried to find a great pulmonologist instead.

Thank you for the link. I'm 71" and 195lbs so I'll dial in a Tv of 600 ml for tonight. dsm maybe a little over-inflated at a Tv of 650 ml. Your link also says I should set this thing 2-3 BPM below my resting breathe rate. I believe my resting breath rate is around 15 BPM.

-SWS wrote:Looking at your post above it sounds as if you might have received a brand new defective machine. I sure hope your new machine is not problematic after all. Good luck.

Thanks dsm! If that little thud is normal at startup (and yes, that same inner component rattles a bit when you shake the machine) the AVAPS is probably fine. I finally got the thing out of Provider (Setup) mode.

Banned

Glad to hear Banned's machine is probably okay after all! And those blower-motor & valve pictures w/descriptions by DSM are superb IMO. Thank you, Doug!

Here's an ASV question by Lubman, should anyone happen to have the answer:
viewtopic/t34459/Lowest-Max-Pressure-on ... st-SV.html

-SWS wrote:Glad to hear Banned's machine is probably okay after all! And those blower-motor & valve pictures w/descriptions by DSM are superb IMO. Thank you, Doug!

Here's an ASV question by Lubman, should anyone happen to have the answer:
viewtopic/t34459/Lowest-Max-Pressure-on ... st-SV.html

SWS,

The Respironics device really is an impressive bit of technology as it can, I believe, adjust air pressure faster & more accurately than any other device I have seen (haven't looked inside a Vpap SV yet). Probably faster than is ever needed but it can do it.

I was a bit puzzled by the customary 'thump' when I bought my 1st Bipap Pro II. I only realised what it was once I had pulled it apart.
All subsequent Bipaps I have purchased incl my Bipap Auto SV have that airvalve.

Cheers

DSM

PS I still regard my BipapAutoSV as a Dream Machine. Have 6 months accumulated data now & lots of interesting feedback as to how damned well it works based on lots of situations. I can't imagine anyone could design a better machine in terms of the quality of sleep and respiration it delivers, also how quiet it is now (I discovered I hadn't tightened the case properly after customarily dismantling it & that caused it to hum for the 1st several weeks until I realized what had happened & tightened it). For the 1st time I can recall, my wife is now a happy sleeper too. She regards this machine as being the best I have ever used. I recently swapped my UM F/F for a Quattro and that is just cream on the cake. Such an improvement of a mask. Again, wife is very pleased at the reduced (next to none) mask noise. To compound my use, I now have a beard & yet don't get that many leaks - but even when I do, the BipapAutoSV eats leaks & can sustain its incredible delivery despite a night of really bad (big black bar on the charts) leaking. It is to me a truly amazing device.

I survived the first night on AVAPS.

The AVAPS works, as advertised, with no mechanical defects.

I could put my experience with AVAPS on a new thread, but I may keep the discussion here for now as people were thinking of this machine as a possible future candidate for Laryssa. This device would never work for Laryssa until she is well able to handle a the minimum tidal volume of 200 ml.

The AVAPS is definitely not a toy, meaning a volume controlled (AVAPS) device is a far less forgiving then a pressure controlled S/T or SV device. When set in AVAPS mode the device is probably pretty close to a true NPPV (Non-invasive Positive Pressure ventilation) machine.

I started the night with the S/T AVAPS settings as follows:

EPAP: 11 cmH2O
IPAP Min: 17 cmH2O
IPAP Max: 25 cmH2O
Tidal Volume (Vt): 600 ml
Breath Rate (BPM): 12
Inspiratory Time (Ti): 1.8 (seconds)
Rise Time: 0.6 (second)

I ended the night as follows:

EPAP: 9 cmH2O
IPAP Min: 12 cmH2O
IPAP Max: 22 cmH2O
Tidal Volume (Vt): 600 ml
Breath Rate (BPM): 11
Inspiratory Time (Ti): 2.1 (seconds)
Rise Time: 0.5 (second)

The most critical parameter with AVAPS is Vt. Without a correct Vt it would be very simple to blow-out a patients lungs with this device. With a Vt oversetting, the patient would fall asleep easily enough, and wake-up in a great deal of trouble.

HighLights: I would like to thank SWS for "suggesting" I re-visit Vt before plugging-in. 600 ml worked well, and got those deeper breaths I was looking for. I also believe I got better sleep than with the Adapt SV, but more time will tell. It is unlikely I will ever need a more than 600 ml Vt. The increased and steady Tidal Volume was a real winner for me.

LowLights There maybe inherent issues with IPAP/EPAP switching in all S/T devices. Or, I may need to play with BPM, Ti, and Rise Time which I probably will anyway. While the steady Tidal Volume was great, the Respironics AVAPS lacked those wonderfully smooth IPAP/EPAP transitions that make the Auto SV and Adapt SV such delightful machines.

Unknown: I did reduce EPAP and IPAP settings. This was in reaction to the increased Tv. I will look at the Encore data in few days.

Overall, I enjoy the increased Tv, and will continue to use the AVAPS, limiting Tv to 600 ml.

dsm wrote:I can't imagine anyone could design a better machine in terms of the quality of sleep and respiration it delivers, also how quiet it is now (I discovered I hadn't tightened the case properly after customarily dismantling it & that caused it to hum for the 1st several weeks until I realized what had happened & tightened it).

I should send you the AVAPS for your 'customary dismantling" LOL!

Banned

I survived the first night on AVAPS.

The Respironics AVAPS device works, as advertised, with no mechanical defects.

I could put my experience with AVAPS on a new thread, but I may keep the discussion here for now as people were thinking of AVAPS as a possible future candidate for Laryssa. This device will never work for Laryssa until she is well able to handle a the minimum tidal volume of 200 ml.

The AVAPS is definitely not a toy, meaning a volume controlled (AVAPS) device is a far less forgiving then a pressure controlled S/T or SV device. When set in AVAPS mode the device is probably pretty close to a true NPPV (Non-invasive Positive Pressure ventilation) machine.

I started the night with the S/T AVAPS settings as follows:

EPAP: 11 cmH2O
IPAP Min: 17 cmH2O
IPAP Max: 25 cmH2O
Tidal Volume (Vt): 600 ml
Breath Rate (BPM): 12
Inspiratory Time (Ti): 1.8 (seconds)
Rise Time: 0.6 (second)

I ended the night as follows:

EPAP: 9 cmH2O
IPAP Min: 12 cmH2O
IPAP Max: 22 cmH2O
Tidal Volume (Vt): 600 ml
Breath Rate (BPM): 11
Inspiratory Time (Ti): 2.1 (seconds)
Rise Time: 0.5 (second)

The most critical parameter with AVAPS is Vt. Without a correct Vt it would be fairly simple to blow-out a patient's lungs. With a Vt oversetting, the patient would fall asleep easily enough, and wake-up in a great deal of trouble.

HighLights: I would like to thank SWS for "suggesting" I re-visit Vt before plugging-in. 600 ml worked well, and got those deeper breaths I was looking for. I also believe I got better sleep than with the Adapt SV, but more time will tell. It is unlikely I will ever need a more than 600 ml Vt. The increased and steady Tidal Volume was a real winner for me.

LowLights There maybe inherent issues with IPAP/EPAP switching in all S/T devices. Or, I may need to play with BPM, Ti, and Rise Time which I probably will anyway. While the steady Tidal Volume was great, the Respironics AVAPS lacked those wonderfully smooth IPAP/EPAP transitions that make the Auto SV and Adapt SV such delightful machines.

Unknown: I did reduce EPAP and IPAP settings. This was in reaction to the increased Tv. I will look at the Encore data in few days.

Overall, I enjoy the increased Tv, and will continue to use the AVAPS, limiting Tv to 600 ml. During the night, I did switch from the Mirage Micro nasal mask, back to the Quattro FF, to help handle the increased Vt

dsm wrote:I can't imagine anyone could design a better machine in terms of the quality of sleep and respiration it delivers, also how quiet it is now (I discovered I hadn't tightened the case properly after customarily dismantling it & that caused it to hum for the 1st several weeks until I realized what had happened & tightened it).

I should send you the AVAPS for your 'customary dismantling" LOL!

Banned

Banned,

If you get a pdf clin manual pls do let me know - I am very interested to see the settings for this machine.

The variety of settings seems to match it to the Vpap III- STA of which I am familiar. From your description
thus far I am surprised that you say how aggressive the pressure can be.

On my BipapAuto SV I rarely am aware of even sudden pressure boosts up to 20 CMs from 14 CMs & just merrily
sleep through the consistent quick bursts that on average reach 20 CMs approx 7-9 or so times per night.

The ipap to epap on the BipapAutoSV is only bettered by the VpapSV. But I noted your issue re that transition.
I also had issues with the Bipap Pro II, Bipap S/T & to a lesser extent the BipapAuto over that pressure switch
happening to soon - I was expecting the same from the BipapAutoSV but was absolutely delighted when that
didn't happen.

Good luck with night 2. I'll very happily stick with my DreamMachine

DSM

PS on further thinking about the inahale / exhale ratio settings & having to set BPM. This machine really
is being set up as a ventilator. Is that BPM setting arbitary or is it as a back-up rate ? - If arbitary, it then
seems to me, you are using a machine designed for someone with serious breathing or lung problems who
needs arbitrary ventilation & I am sure that is not a problem you have. SV stills stands out as the better bet.

Banned,

Have looked thru the AVAPS manual & am going to predict the following

1) The machine if set in S/T mode with and BPM close to your normal nightly breathing rate, may
well annoy you greatly. The Timed breathing mechanism on the AVAPS is far too tightly controlled.

2) You will give up on this machine - your Vpap Adapt SV is going to be easier to tolerate.

3) Once you try a Bipap Auto SV, you'll wonder why you tried the AVAPS and you'll understand
what I have meant by the Vpap Adapt SV being too much in control and the Bipap AVAPS looking
like it acts the same - the Vpap Adapt SV just looks like an automated version of the AVAPS ).

My own conclusion based on trialling the other 2 & what you have said & what the Clinical manual says,
is that the AVAPS is only suited to special well understood respiratory ailment cases. e.g. CA with
additional complications - Cheynes-Stokes patients - People who have problems regulating their
breathing due to lung ailments COPD) - aged patients needing ventilation.

Both the Vpap Adapt SV & the Bipap AVAPS appear to target the same patient set. The Bipap Auto SV
seems on its own as a rather unique experiment by Respironics that IMHO does more than they ever
imagined it might. I sure would like to meet the designers to discuss why they did things they way
they did & did they ever appreciate the beneficial side effects it produces. I sure hope they see it as
a platform for their next market taming range of advanced models. They just need to work on their
variable speed motor fan arrangement in any newer SV machines. The basic SV xPAP algorithm is an
outstanding achievement (just as the blower assembly in the Vpap Adapt SV is).

DSM

dsm wrote: PS on further thinking about the inahale / exhale ratio settings & having to set BPM. This machine really
is being set up as a ventilator. Is that BPM setting arbitary or is it as a back-up rate ? - If arbitary, it then
seems to me, you are using a machine designed for someone with serious breathing or lung problems who
needs arbitary ventilation & I am sure that is not a problem you have. SV stills stands out as the better bet.

I am currently running the BiPAP AVAPS in S/T mode, and as I understand it, Spontaneous/Timed means 'back-up rate' as the machine will trigger with the patients own breath, or generate a back-up breath if no breath is detected. The AVAPS can also be run in PC (Pressure Control) mode, meaning all PC breaths are machine generated (arbitary if you will) even though the patient can still breath spontaneously in PC mode. PC AVAPS mode does provide the arbitary (NPPV) ventilation, of which you speak.

My only interst in AVAPS is it's ability to assure an average tidal volume that is 16-17% more than the average tidal volume I could get out of the Adapt SV. That doesn't sound like much, but when your breathing always feels a little light (shallow) on the SV, that extra volume certainly feels better. Also, over the years I have some mild, intermittent, shortness of breath issues that can occur during daily activity so the AVAPS is experimental, for me.

The downside of the Respironics AVAPS is that it is not a BiPAP 'Auto' AVAPS device, meaning it does not sample on a breath-by-breath basis and does not offer those smooth IPAP/EPAP transitions that you and I have grown to love with the SV (unless there is an secret to the AVAPS that I haven't discovered yet).

You will not need to trial an AVAPS device because your average tidal volume of 650 ml will never be a problem for you. I'm simply weighing in on whether the extra 16-17% assured average volume is a happier trade-off than those lovely breath-by-breath transitions with the SV. After all, I'm the comfort guy!

Banned

Banned,

I can actually tune my Tidal Volume by adjusting the IpapMAX setting. I think (I'll need to check) that
I have been able to vary it in the vacinity of 15% or thereabouts.

I am more convinced than ever that breath-by-breath machines do work (excluding special case needs)
and work well. But that they need further refining & thus far would put the Bipap Auto SV slightly
ahead of the Vpap Adapt SV for comfortable use by ordinary xPappers vs special needs people.

I am certain if I could make some mods to the Vpap Adapt SV I could make it into a more general
purpose machine offering that magic breath-by-breath PS that turns sleeping into such a great
nightly event.

(I guess we should shift this out of Laryssa's thread)

Cheers & happy sleeping

DSM

dsm wrote: I can actually tune my Tidal Volume by adjusting the IpapMAX setting. I think (I'll need to check) that
I have been able to vary it in the vacinity of 15% or thereabouts.

If you can find a way to tweak 15% more Average Tidal Volume out of an BiPAP Auto SV, let me know. More importantly, let Laryssa's doctor's know!

Banned