CPAP
Machines
| DS400 |
The M-Series Remstar Pro is
a CPAP unit designed for patient who require use of
the Encore Pro Smart Card and Data Down-Load. |
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If you do not see the machine you are interested in
purchasing - please call us. |
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CPAP Machine
Continuous pressure devices
Fixed-pressure CPAP (Continuous Positive Airway Pressure)
provides one constant pressure to the patient
APAP or AutoPAP or AutoCPAP (Automatic Positive Airway Pressure)
automatically titrates, or tunes, the amount of pressure
delivered to the patient to the minimum required to maintain
an unobstructed airway on a breath-by-breath basis by measuring
the resistance in the patient's breathing, thereby giving
the patient the precise pressure required at a given moment
and avoiding the compromise of fixed pressure.
Bi-level pressure devices
VPAP or BiPAP (Variable/Bilevel Positive Airway Pressure)
provides two levels of pressure: Inspiratory Positive Airway
Pressure (IPAP) and a lower Expiratory Positive Airway Pressure
(EPAP) for easier exhalation.
Modes
S (Spontaneous) - In spontaneous mode the device triggers
IPAP when flow sensors detect spontaneous inspiratory effort
and then cycles back to EPAP.
T (Timed) - In timed mode the IPAP/EPAP cycling is purely
machine-triggered, at a set rate, typically expressed in
breaths per minute (BPM).
S/T (Spontaneous/Timed) - Like spontaneous mode, the device
triggers to IPAP on patient inspiratory effort. But in spontaneous/timed
mode a "backup" rate is also set to ensure that
the patient still receives a minimum number of breaths per
minute if they fail to breathe spontaneously.
Components
Flow generator (PAP machine) provides the compressed air
Hose connects the flow generator (sometimes via an in-line
humidifer) to the inferface
Interface (nasal or full face mask, nasal pillows, or less
commonly a lipseal mouthpiece) provides the connection to
the user's airway
Optional features
Humidifier adds moisture to the air
Heated: Heated water chamber that can increase patient comfort
by eliminating the dryness of the compressed air. The temperature
can usually be adjusted or turned off to act as a passive
humidifier if desired.
Passive: Air is blown through an unheated water chamber
and is dependent on ambient air temperature. It is not as
effective as the heated humidifier described above, but
still can increase patient comfort by eliminating the dryness
of the compressed air.
Ramp is used to temporarily lower the pressure to allow
the user to fall asleep more easily. The pressure gradually
rises to the prescribed level over a period of time that
can be adjusted by the patient and/or the DME provider.
Exhalation pressure relief: Gives a short drop in pressure
during exhalation to reduce the effort required. This feature
is known by the trade name C-Flex in some PAPs made by Respironics
and EPR in ResMed machines.
Flexible chin straps are used to help the patient not breathe
through the mouth, thereby keeping a closed pressure system.
The straps are elastic enough that the patient can easily
open his mouth if he feels that he needs to.
Data logging records basic compliance info or detailed event
logging, allowing the sleep physician (or patient) to download
and analyze data recorded by the machine to verify treatment
effectiveness.
Such features generally increase the likelihood of PAP tolerance
and compliance. [3]
Care and maintenance
As with all durable medical equipment, proper maintenance
is essential for proper functioning, long unit life and
patient comfort. The care and maintenance required for PAP
machines varies with the type and conditions of use, and
are typically spelled out in a detailed instruction manual
specific to the make and model.
Most manufacturers recommend that
the end user perform weekly maintenance. Units must be checked
regularly for wear and tear and kept clean. Worn or frayed
electrical connections may present a shock or fire hazard;
worn hoses and masks may reduce the effectiveness of the
unit. Most units employ some type of filtration, and the
filters must be cleaned or replaced on a regular schedule.
Hoses and masks accumulate exfoliated skin, particulate
matter, and can even develop mold. Humidification units
must be kept free of mold and algae. Because units use substantial
electrical power, housings must be cleaned without immersion.
Portability
Since continuous compliance is an important factor in the
success of treatment, it is of importance that patients
who travel have access to portable equipment. Progressively,
PAP units are becoming lighter and more compact, and often
come with carrying cases. Dual-voltage power supplies permit
many units to be used internationally.
Air travel presents special considerations.
Most airport security inspectors have seen the portable
machines, so screening rarely presents a special problem.
Increasingly, machines are capable of being powered by the
400 Hz power supply used on most commercial aircraft and
include manual or automatic altitude adjustment.
Some patients on PAP therapy also
use supplementary oxygen. When provided in the form of bottled
gas, this can present an increased risk of fire and is subject
to restrictions. (Commercial airlines generally forbid passengers
to bring their own oxygen.) As of November, 2006, most airlines
permit the use of oxygen concentrators.
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