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RESmart® Auto-CPAP
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1. 5 the higher the speed of pressure adjustment increasing or decreasing When respirations increases rapidly and suddenly as during waking the treatment pressure decreases rapidly for patient comfort Definitions Avg Daily Compliance H M Average time of patient use of the device in nightly therapy Average P95 cmH20 Auto pressure at or below the pressure 95 percent of that it is in use Mean Pressure cmH20 The mean pressure level in hPa delivered within the selected range AHI Apnea Hypopnea Index AHI represents the average number of the apnea and hypopnea per hour for the timeframe SNI RESmart AutoCPAP Clinician s Manual CHANGING DEVICE SETTINGS To enter the clinician s mode for the device remove the power cord from the RESmart unit Press and hold both the start and ramp buttons simultaneously while reconnecting the power cord The RESmart unit may now be programmed with therapy options You may step through each of the options using the and buttons on the device To change a setting press the ramp button Confirm your setting by pressing ramp a second time Setting options include Mode CPAP Titrate or Auto Treat P set the treament pressure Max APAP set the maximum treatment pressure Ramp Set ramp time from starting pressure to treatment pressure in minutes Default time is 10 minutes Init P set the starting ramp pressure Default setting is 4 5 cmH20 Unit cmH20 or hPa Us
2. patients with the following pre existing conditions e Bullous Lung Disease e Bypassed Upper Airway e Pneumothorax e Pathologically Low Blood Pressure e Pneumocephalus has been reported in a patient using nasal Continuous Positive Airway Pressure Caution should be used when prescribing CPAP for susceptible patients such as those with cerebral spinal fluid leaks abnormalities of the cribriform plate prior history of head trauma and or pneumocephalus Chest 1989 96 1425 1426 e The use of positive airway pressure therapy may be temporarily contraindicated if you exhibit signs of a sinus or middle ear infection Contact your health care professional if you have any questions concerning your therapy Adverse Effects Patients should report unusual chest pain severe headache or increased breathlessness to their prescribing physician An acute upper respiratory tract infection may require temporary discontinuation of treatment RESmart AutoCPAP Clinician s Manual Indicative mask pressure 0 SERB BERBER ERE a ad lel e g s I l 1 j J Flow l min Pressure cm H20 A SL E RESlex TREATMENT Time Sensitivity The speed of pressure adjustment can be modified to improve patient comfort A lower sensitivity setting corresponds to a more gradual pressure adjustment The higher the sensitivity setting the faster the speed of pressure adjustment For example at a Sensitivity setting of
3. 3B 3B Medical Inc 1142 N Scenic Highway Lake Wales FL 33844 USA Email info 3Bproducts com Tel 863 226 6285 Fax 863 226 6284 3B BN RESmart Auto CPAP CLINICIAN S MANUAL 3 BO RESmart Auto CPAP B MO CLINICIAN S MANUAL Indications for Use The RESmart APAP system is a CPAP Continuous Positive Airway Pressure device designed for the treatment of adult Obstructive Sleep Apnea OSA only RESmart has three treatment modes Auto Titrate and fixed pressure CPAP The RESmart APAP is to be used only on the instruction of a licensed health care professional Your home care provider will make the correct pressure settings according to your health care professional s prescription Several accessories are available to make your OSA treatment with the RESmart AutoCPAP system as convenient and comfortable as possible To ensure that you receive the safe effective therapy prescribed for you use only BMC accessories are recommended IMPORTANT Read and understand the entire user manual before operating this system If you have any questions concerning the use of this system contact your home care provider or health care professional Contraindications The RESmart APAP is not a life support device and may stop operating with power failure or certain fault conditions It should not be used by patients who are dependent on continuous therapy Positive airway pressure therapy may be contraindicated in some
4. e time Useage hours of the device Mask test Important to save settings you must advance through all setting options until you encounter the Save prompt Hit ramp to confirm settings RESmart AutoCPAP Clinician s Manual The following side effects may arise during the course of therapy with the RESmart device e Drying of the nose mouth or throat e Nosebleed Bloating e Ear or sinus discomfort e Eye irritation e Skin rashes e Chest discomfort Auto Mode The treatment pressure required by the patient may vary through the night and from night to night due to changes in sleep states body position and airway resistance RESmart provides only sufficient pressure to maintain upper airway patency You can set the initial and maximum allowable treatment pressures RESmart analyzes the state of the patient s upper airway on a breath by breath basis and delivers pressure within the allowed range according to the degree of obstruction Auto Mode improves patient compliance through enhanced algorithm of Auto Mode AutoSet algorithm auto adjusts to maintain optimal therapy pressure The pressure can vary from treat pressure Treat P to maximum treat pressure Max APAP which is shown as below Pressure Max APAP Treat P Initial P e RESmart Auto Pressure adjusts treatment pressure as a function of four parameters Apnea Snore Flow Limitation and Hypopnea Apnea An apnea is defined as a
5. greater than 80 decrease in ventilation After scores 2 apneas within 3 minutes treatment pressure will rise The rising speed is inverse proportion to current pressure namely the higher current pressure the lower rising speed Treatment pressure stops rising when normal ventilation and no snore If ventilation keeps normal for several minutes treatment pressure will decrease The descending speed is direct proportion to current pressure namely the higher current pressure the higher descending speed 3 RESmart AutoCPAP Clinician s Manual When treatment pressure approaches 10hPa cmH20 during rising not only rising speed will decrease greatly but also snore or flow limitation must be detected for increasing pressure This is to prevent an inappropriate response to central apneas Snore When a patient snores sound is generated and the inspiratory flow time curve is distorted by the frequency of the sound RESmart detects and calculates snore level breath by breath When snore sound intensity exceeds 50 higher than background noise then one snoring event is scored Treatment pressure increases after continuing 3 snores The rising speed is inverse proportion to current pressure namely the higher current pressure the lower rising speed Snore Index SNI represents the mean snore count per hour Snore Level is index for degree of patient snoring It is the percentage of all breathes with snoring event For example 20 means 20 b
6. making the overall therapy more comfortable The features of RESlex are e RESlex is disabled automatically in the event of an apnoea RESlex resumes automatically when the apnoea event has passed e You can select a RESlex pressure drop of 0 1 2 or 3 maximum drop is 3 cm H20 e Pressure drop is limited to avoid sub optimal treatment e When RESlex is enabled the delivered pressure will not drop below a minimum pressure of 4 cm H20
7. mode Contrarily when treatment pressure is decreasing if current pressure is lower than Treat P the decreasing speed is normal If current pressure is higher than Treat P the decreasing speed is doubled Significance of Auto and Titrate Mode The Titrate Mode is based on manual titration and its algorithm is sensitive to respiratory events Advantages it can decrease AHI effectively and compute the P95 pressure accurately Disadvantages it has large pressure range the pressure changing is easy to cause the patient discomfort The APAP combines the Titrate Mode with new Auto Mode to effectively adjust the pressure for maximum comfort with the premise of effective treatment To get a accurate P95 pressure Titrate Mode is applicable for the first 1 2 weeks during the use Based on the P95 pressure MAX APAP is determined It is suggested to set the MAX APAP little higher 1or 2 cm H20 than P95 pressure And based on the Pmean pressure Treat P is determined It is suggested to set the Treat P little lower 1or 2 cm H20 than Pmean pressure It can improve patient s compliance with more accurate and humane pressure range RESlex In Auto mode you can select expiratory pressure relief RESlex RESlex is designed to maintain optimal treatment pressure for the patient during inhalation and reduce the delivered mask pressure during exhalation The desired result of RESlex is to decrease the pressure the patient must breathe out against
8. reathe along with snoring in all 100 breathes Flow Limitation Flow Limitation is the partial airway closure without snore As the upper airway begins to collapse the shape of the inspiratory flow time curve changes and the central section flattens RESmart analyzes the curve shape of each breath and calculates the distortion Flow Limitation usually precedes snoring and obstruction Detection of Flow Limitation enables the device to increase the pressure before obstruction occurs making treatment pre emptive This is also the important criterion for obstruction and central apnea Hypopnea A hypopnea is defined as a 60 80 decrease in ventilation After scores 6 hypopneas within 3 minutes treatment pressure will rise Titrate Mode For the previous Auto Mode of APAP after Ramp time the pressure will increase from Init P to Treat P Once respiratory events appear the treatment pressure increases if there is no occurrence of respiratory events the treatment pressure drops The pressure range the minimum is Init P and the maximum is Max APAP Pressure Adjustment of the Titrate Mode is shown as below Pressure 4 Max APAP TreatP Initial P Pressure change in Titrate Mode When treatment pressure is rising if current pressure is lower than Treat P the rising 4 RESmart AutoCPAP Clinician s Manual speed is doubled If current pressure is higher than Treat P the rising speed is normal as Auto
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