AutoSv Respironics Min and Max PS

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AutoSv Respironics Min and Max PS

Postby kimmysue31 » Tue Feb 04, 2014 9:51 am

Would appreciate help with reasons to change Min and Max PS setting during auto titration. I need help, in simple terms, because everything I have read is apparently over my head and I am just not grasping it. Any and all help/direction will be much appreciated. Thanks in advance!
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Postby respbarb » Tue Feb 04, 2014 5:59 pm

Call your Respironics and ask for an inservice
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AutoSV

Postby kimmysue31 » Tue Feb 04, 2014 10:50 pm

respbarb wrote:Call your Respironics and ask for an inservice


Been there done that and didn't help. Figured help from someone with more hands on would be more appropriate.
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Postby MastaFunk » Wed Feb 05, 2014 12:13 am

Inspiratory pressure varies to meet the target ventilation. A component of ASV mode. Simply put: almost an auto-support when needed.


• Psmin
– The minimum amount of pressure support (i.e.
minimum difference between the EPAP and the
PSmin setting)
• PSmax
– The maximum amount of pressure support (i.e.
maximum difference between the EPAP and
the PSmax)

Simply responds to all decreases in flow or minute ventilation... as it states; Pressure Support.
It is basically the Pressure needed to obtain the optimal vent...their corresponding PS# will be used on final pressure Rx to achieve the "optimal pressure" that has been pre-determined by the MD.

I agree with Barb, or have the medical Director sit with you, and give you the run-down. In my experience Respironics tech support hotline is a great resource...
Res Med is 'fixed at PS/3 as an example of another system.

It is always better not to attempt to use something you don't fully 'get', until you can atleast have a basic grasp and the support of your MD. We all have to learn, just don't make a mistake the patient or you, will regret.
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Postby somnus diabolus » Wed Feb 05, 2014 10:46 pm

Reasons for Max PS are a bit trickier. Starting to get into some long explanations there. An easy one would be if a PS of say 15 is causing the seal to break between the mask and the Pt.
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Auto

Postby kimmysue31 » Thu Feb 06, 2014 10:32 am

Thanks for all the responses. Have read many threads on here about auto and seems the consensus is that they are a bit tricky and unpopular by a lot of techs. Odd to me is that Respironics algorithm has no protocol for PS min changes.
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Re: Auto

Postby munkyBeatz » Fri Feb 07, 2014 9:08 pm

kimmysue31 wrote:Thanks for all the responses. Have read many threads on here about auto and seems the consensus is that they are a bit tricky and unpopular by a lot of techs. Odd to me is that Respironics algorithm has no protocol for PS min changes.


They're really not as bad as you would think, especially since for the most part certain docs will order autoSV when it really wasn't necessary.

In response to your original question on PSmin/max. For the purposes of the AutoSV the PSmin will depend on whether you're performing a cPAP with autosv [less common] or BiPAP with autoSV. The machine is capable of both.

PSmin:
So of course with say a BiPAP ASV, you're min should be started with 4cmH20 and could need some tweaking later in night if you have the special complex cases that need a larger minimum pressure support [e.g. 5cmH20] to clear certain central/mixed/etc type respiratory.

PSmax:
Now as for this one, you pretty much are just wanting to leave it set at the high end setting and you're really not going to adjust this throughout the titration. Due to the complex type patients that require this treatment, you are primarily titrating mainly for the pressure support range that they require throughout the night. This setting is something that is to be set by the physician when they go to prescribe the equipment. So if the patient never needed a pressure support maximum over say 7cmH20, then the MD will change the values to reflect that.

The machine [from respironics stand point] is doing the titration for you, and you shouldn't be doing a whole lot of adjusting. It's kind of hard, but for the most part you feel a bit useless during one of these titrations, other than the trying to turn off the normal sleep tech titration mode impulses in your head.
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