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Need help with Avap setting

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noska

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I got best friend in Russia with ALS 60 years old guy and send him Respironics Legacy Series BIPAP last year (thank you for advise from forum).
They had doctor who recommended setting. Everything was great. Than recently doctor change settings (increased) and quit the job. My friend realize in few days that air is blowing too strong and he struggles to breathe but doctor is no longer there and no other doctors around who know what settings on machine is needed to be changed to. If anybody could give some advise what settings he could reduce/change since my friend knows how to change, just no idea what to set
Appreciate for help!
 

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KarenNWendyn

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The IPAP (pressure delivered with each inhaled breath) is set at 16 which is too high for him. Try lowering this to 10, and then if he seems to tolerate that, increase it to 12. Meanwhile, he needs to find a new doctor to help with this.
 

noska

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Thank you so much. They are trying to find another doctor, but machines like this still rare in Russia
 

lgelb

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Do you know where the IPAP was before? I would start back at that level, if it was comfortable, or, if not, start at 8 and go up one step at a time. Someone can tell if the IPAP is right in just a few seconds. Sometimes people need a lower IPAP as time goes on, and sometimes higher. But with an EPAP of 4, you want to start at 8 and inch up if/as needed ifi you are doing a "reset" and don't have previous settings.
 

noska

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at the begining was IPAP 10, EPAP 4. I told him try 12
 

KarenNWendyn

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Hopefully he will tolerate IPAP of 12. If he doesn’t, the other thing to look at is the backup rate or breaths per minute (BPM).

I see this is set to 15. 15 is a fairly fast rate. That would be appropriate for someone who can not initiate breaths on their own at all. If he still can initiate breaths and doesn’t tolerate the IPAP of 12, then consider lowering the backup rate to somewhere between 12-14.
 

lgelb

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The ideal is not to trigger the backup rate, though, so you want to set it low -- 8 is fine as a starting point. It's good to watch the screen or read the data card to see if it's being triggered, also, because that would suggest trying different settings.
 
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