Trilogy 100 IPAP

[bkite]

Hi Laurie
I need to increase the IPAP on my Trilogy. The Pulmonologist clinic is taking too long to respond. The manual won't instruct how to get into the pressure and volume settings.
Thanks
Bruce

 

[KimT]

Bruce,

To read or change the settings you push the alarm button and the down arrow button (hold) until you hear a beep. Then use the down arrow button to settings and alarms. Then select it by pushing the button on the right under where it reads SELECT. Once you select any field, you can use the up and down buttons to change values.

Once you can read your settings, you can tell Laurie what they are and go from there.

Make sure your Trilogy is not locked. If it is you'll have to unlock it first.

 

[lgelb]

Bruce,
In addition to how Kim mentioned to unlock the machine, you may also first need to set Menu access to Full and you should also set View to Detailed so you have more information that can help optimize your settings.

Also if you do not have pre-existing sleep apnea, you should try moving your EPAP to 4, if it is not, before adjusting IPAP or target volume (usually it is best to stay on AVAPS mode and adjust the latter). Let me know if you need to fine-tune any other settings, e.g. speed, duration, interval between breaths, how fast the air comes initially.

Best,
Laurie

 

[bkite]

Apparently, the respiratory tech told us that the machine is locked. Is there a way that we can unlock it?

 

[lgelb]

As Kim said, hold down the alarm button and the down arrow button together until you hear a beep. Then go into the menu (Options) and change Menu Access to Full and View to Detailed. Then you can do the rest and see more data.

 

[bkite]

Bruce,
In addition to how Kim mentioned to unlock the machine, you may also first need to set Menu access to Full and you should also set View to Detailed so you have more information that can help optimize your settings.

Also if you do not have pre-existing sleep apnea, you should try moving your EPAP to 4, if it is not, before adjusting IPAP or target volume (usually it is best to stay on AVAPS mode and adjust the latter). Let me know if you need to fine-tune any other settings, e.g. speed, duration, interval between breaths, how fast the air comes initially.

Best,
Laurie

I finally talked Joyce into going in the menus. Here they are.

Dual Prescription: off
Mode: AVAPS-AE
AVAPS Rate: 2.0 cm H₂O
Tidal Volume: 530
Maximum Pressure: 30.0
Pressure Support Max: 10
Pressure Support Min: 5
EPAP max: 4
EPAP min: 4
Breath Rate: auto
Trigger type: auto trak
Rise Time: 3
Ramp Length: Off

Thanks so much
Bruce

 

[lgelb]

Height and weight, smoking history, lung disease? (To recommend target volume)

In any event, first change I'd make would be taking minimum pressure support (PS) to 6 from 5. As for your max IPAP, it's set very high but is being constrained by 10 max PS (since your EPAP=4, your IPAP can't exceed 14). So if you are air-starved, you can increase that to 12. And take AVAPS rate up to 3. I wouldn't go past that without looking at some other settings, like TV.

Best,
Laurie

 

[bkite]

Height and weight, smoking history, lung disease? (To recommend target volume)

In any event, first change I'd make would be taking minimum pressure support (PS) to 6 from 5. As for your max IPAP, it's set very high but is being constrained by 10 max PS (since your EPAP=4, your IPAP can't exceed 14). So if you are air-starved, you can increase that to 12. And take AVAPS rate up to 3. I wouldn't go past that without looking at some other settings, like TV.

Best,
Laurie

Dear Laurie

I am so grateful for your guidance. I adjusted the PS max and min, the AVAPS Rate, all as you recommended. I am sleeping better, not using as steep of an elevation on the head of the bed.
The TV definitely needs to increased. When I watch the Trilogy screen, my Vte is ranging between 700 and 850.
My history and physical:
Height 72"
Weight 175 pre-ALS
Weight 130 currently

History
never smoked
no pulmonary diseases

Pre-ALS activity level
Elite recreational cyclist, riding 2000 miles per year.

Thank you
Bruce

 

[lgelb]

Hi Bruce,
That's an impressive TV even for being awake. Just to dot all the i's, are we sure you have no leak in your system and that the exhaust flapper valve in your mask is working properly?

And have you checked/cleaned the filters in the machine lately?

After that, yes, I'd increase the target -- maybe to 620 and depending on your sleep/how you feel, go (probably up but not necessarily to your awake level) from there. It's better to start low/go slow. We may need to increase the PS max but that could drift into IPAP some masks/lungs can't handle, so let's try from the other end first.

How is the shape of the breaths now? Does the air come when/how fast/how long you need it? You might have Joyce watch you at some point for a more awake point of view.

Also be sure you check humidification and room temp as pushing more volume may change the settings you need there. Glad you are sleeping better.

 

[bkite]

Hi Bruce,
That's an impressive TV even for being awake. Just to dot all the i's, are we sure you have no leak in your system and that the exhaust flapper valve in your mask is working properly?

And have you checked/cleaned the filters in the machine lately?

After that, yes, I'd increase the target -- maybe to 620 and depending on your sleep/how you feel, go (probably up but not necessarily to your awake level) from there. It's better to start low/go slow. We may need to increase the PS max but that could drift into IPAP some masks/lungs can't handle, so let's try from the other end first.

How is the shape of the breaths now? Does the air come when/how fast/how long you need it? You might have Joyce watch you at some point for a more awake point of view.

Also be sure you check humidification and room temp as pushing more volume may change the settings you need there. Glad you are sleeping better.

The flapper valve gets washed with the mask regularly and system leaks are usually 25 on the display.
Filters are maintained.
Breath shape is comfortable. The rate varies to suit me and is there when I need.
Thank you so much.
Bruce

 

[chally]

Thanks Bruce & Laurie for the help with trilogy 100.
After fooling with it my daughter and I have got all the settings amiss .
Thankful I have two of these machines and can go back to the other one.
10 seems a bit weak and 15 a bit to much,we raised the iPapto 12 and that seems to bring the gauge of air flow up to 12 ?
Not meaning to hijack thread, Laurie I sent ya an email.
Chally

 

[lgelb]

I responded to your email, Chally.

Best,
Laurie