Philips RESPIRONICS Trilogy Mode D'emploi page 16

AVAPS-AE Therapy
Information on AVAPS-AE in this addendum replaces information presented in previous Trilogy manual instructions and addendum.
AVAPS-AE is a Bi-level therapy mode that automatically adjusts Expiratory Positive Airway Pressure (EPAP), Pressure
Support, and the backup breath rate. AVAPS-AE monitors the resistance in the patient's upper airway and adjusts EPAP
automatically to maintain a patent airway. AVAPS-AE mode also monitors delivered tidal volumes and automatically adjusts
pressure support to maintain the designated target tidal volume. AVAPS-AE also has the ability to automatically set and
maintain a backup breath rate (max 20) based on the patient's own spontaneous breathing rate. AVAPS-AE is intended for
non-invasive applications only.
The AVAPS-AE therapy mode is contraindicated for invasive use and patients less than 10 kgs.
AVAPS-AE is enabled in the Settings and Alarms Screen. When in AVAPS-AE mode, the AVAPS feature is always enabled.
Similar to AVAPS, AVAPS-AE supports tidal volumes from 50 to 2000 ml (in 5 ml increments).
The following new parameters should be set to ensure appropriate therapy delivery and maximize patient comfort:
• Maximum Pressure: When in AVAPS-AE mode, the Maximum Pressure delivered can be set from 6 to 50 cm H
in increments of 1. Settings lower than the maximum setting of 50 cm H
• Pressure Support Max: When in AVAPS-AE mode, Pressure Support Max can be set from 2 to 40 cm H
increments of 1. This setting may be limited by the Maximum Pressure setting and EPAP Min Pressure setting.
• Pressure Support Min: When in AVAPS-AE mode the minimum pressure support may be set from 2 to 40 cm
H O in increments of 1. It may not exceed the Pressure Support Max setting. This setting may be limited by the
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Maximum Pressure or EPAP Max Pressure setting.
• EPAP Max Pressure: When in AVAPS-AE mode, the EPAP Max Pressure can be set from 4 to 25 cm H
increments of 1. This setting cannot be lower than the EPAP Min Pressure and may be limited by the Maximum
Pressure setting and Pressure Support Min setting.
• EPAP Min Pressure: When in AVAPS-AE mode, the EPAP Min Pressure can be set from 4 to 25 cm H
increments of 1. This setting cannot exceed EPAP Max Pressure and may be limited by the Maximum Pressure
setting and Pressure Support Min setting.
• Breath Rate: When in AVAPS-AE mode, the breath rate can be set from 0 (off) to 60 BPM. The breath rate can
also be set to "Auto".
Note: When "Auto" Breath Rate is selected, the Inspiratory Time will be set by the device and is not user settable.
AVAPS-AE Troubleshooting
Question: Why can't I increase my Pressure Support Max to the full range of 40 cmH
Answer: Some settings, such as Pressure Support Max, can be limited by other pressure settings. For example, reducing
the Maximum Pressure setting will impose the same reduction on the Pressure Support Max capability of the device.
Increasing the EPAP Min Pressure will also reduce the Pressure Support Max that can be applied. You may have to modify
one setting in order to extend the range of another setting.
Question: What happens if the device needs to increase EPAP but the Maximum Pressure setting has already been reached?
Answer: The EPAP will increase as high as the EPAP Max Pressure setting. The amount of Pressure Support applied may
be reduced in order to reach the EPAP Max setting. Airway patency and hence the EPAP pressure will take precedence
over Pressure Support in these situations.
Question: How does the Ramp function work when using AVAPS-AE?
Answer: Ramp: Activation of the Ramp Feature in AVAPS-AE will reset the EPAP setting to the EPAP Min Pressure and restart
the Auto EPAP algorithm. Additionally, the Pressure Support will be reduced to the Pressure Support Min level and ramp as
high as the Pressure Support Max, as required by the AVAPS algorithm, to allow for a comfortable transition to sleep.
Note: If using AVAPS, the pressure support capability will ramp from the IPAP Min (or Pressure Support Min) to the IPAP Max
(or Pressure Support Max).
O may limit other pressure settings.
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