VPAP™ III & III ST - Sleep Restfully, Inc.
Contents
1. 4 Connect the free end of the medium air tubing to the air outlet of the VPAP H 3 5 Connect the mask system to the free end of the long air tubing The final assembly should look like figure H 4 6 If the VPAP is not already plugged in see Step 2 on page 7 WARNING Make sure that the power cord and plug are in good condition and the equipment is not damaged 7 Navigate to the humidifier setting if available in the VPAP menu and select PASSOVER See How to Use the Detailed Menu if enabled by your Clinician on page 20 The VPAP is now ready for use with the ResMed Passover To start treatment see Starting Treatment on page 13 Setting up the VPAP System 9 Using the LCD Screen and Keypad The control panel of the VPAP includes an LCD screen and keypad y Pap IM LCD screen Left key Up down key LCD Screen The LCD screen displays the menus and treatment screens C3 To assist you in adjusting the VPAP the keypad and LCD are equipped with a backlight The LCD backlight comes on when the unit is turned on or when you press a key and turns off after two minutes Keypad Keys The VPAP keypad has the following keys Key Function Front e Starts or stops treatment jew e Extended hold for at least three seconds starts the re Mask Fitting feature Up Down e Allows you to scroll through the VPAP menus 8 submenus and setting options Key Function Left green2. Setting Up The VPAP 1 Place the VPAP unit on a flat surface near the head of your bed If the unit is placed on the floor ensure that the area is free from dust and clear of bedding clothes or any other objects that could block the air inlet CAUTION Be careful not to place the device where it can be bumped or where someone is likely to trip over the power cord 2 Connect the power cord to the socket at the rear of the flow generator Plug the other end of the power cord into a power outlet D 1 WARNING Make sure the power cord and plug are in good condition and the equipment is not damaged The air filter cover protects the device in the event of accidental liquid spillage onto the device Ensure that the air filter and air filter cover are fitted at all times 3 Connect one end of the air tubing firmly onto the air outlet of the unit D 2 WARNING Only ResMed air tubing should be used with your flow generator A different type of air tubing may alter the pressure you actually receive and reduce the effectiveness of your treatment 4 Assemble your mask system according to the mask user instructions 5 Connect your mask system to the free end of the air tubing D 3 The VPAP system is now assembled D 4 To start treatment see Starting Treatment on page 13 Attaching a Humidifier WARNING When using a humidifier position it lower than you and at the same level or lower than the VPAP Setting up the VPAP
3. IEC60601 1 2 test level Compliance level Electromagnetic environment guidance Conducted RF IEC 61000 4 6 Radiated RF IEC 61000 4 3 3 Vrms 150 kHz to 80 MHz 10 V m 80 MHz to 2 5 GHz 3 Vrms 10 V m Portable and mobile RF communications equipment should be used no closer to any part of the VPAP including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance d 1 17 VP d 0 35 VP 80 MHz to 800 MHz d 0 70 VP 800 MHz to 2 5 GHz where P is the maximum output power rating of the transmitter in watts VV according to the transmitter manufacturer and d is the recommended separation distance in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference mav occur in the vicinitv of equipment marked with the following svmbol o OTE At80 MHz and 800 MHz the higher frequency range applies OTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people norma reorienting or relocating the VPAP a Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and and mobile radios amateur radio AM and F
4. After the device self checks are complete the VPAP or Ramp screen appears Ramp Screen If your clinician has set a maximum ramp time the Ramp screen is displayed after the Welcome screen On the Ramp screen you can immediately set a ramp time Ramp time is the period during which the pressure increases from a low pressure to the prescribed treatment pressure See Ramp time on page 13 Ramp time can be altered in five minute increments from OFF to a maximum ramp time set by your clinician by using the Up Down key How to Use the Standard Menu The standard menu allows you to view details about the time used and the current software version of your VPAP The Used time screen displays the total number of hours for which the device has been used It also displays the number of days the VPAP was used out of the total number of days available for use Figure 1 Summarizes the VPAP standard menu series How to Use the VPAP Menus 19 20 VPAP screen Ramp screen Options RESMED VPAP III RAMP 20min OFF 5 10 15 20 25 Set menu gt 15 20 25 30 35 40 45 min USED 00000hrs 00000 00000days View only SW on View only exit Figure 1 VPAP Standard Menu Series To access the VPAP menus Press the Left key menu while the VPAP or Ramp screen is displayed To scroll through items within the menu Press the Up Down key To exit out of the menu Press the Right key exit How to Use t
5. Alarm signal is activated Settings for Mask Types The following table shows the setting that should be selected for each mask type Table 3 Settings for mask types Settings Mask MIRAGE Mirage Nasal Mask ULTRA Ultra Mirage Nasal Mask How to Use the VPAP Menus 23 24 Settings Mask STANDARD Mirage Activa Nasal Mask Mirage Vista Nasal Mask Modular Nasal Mask MIR FULL Mirage Full Face Mask Mirage Full Face Mask Series 2 Ultra Mirage Full Face Mask Results Menu Note This menu appears only if at least one Smart Data option has been enabled by the clinician See the VPAP Ill Smart Data Diary for further details Table 4 Results Menu Function Function Description Setting Options Mask Fit Displays a star rating corresponding to View only Smart Data the mask leak from the previous session See Table 1 on page 15 for mask fit star rating description Usage Displays usage hours from the previous View only Smart Data session See Table 1 on page 15 for mask fit star rating description Options Menu Table 5 Options Menu Function Default Function Description The Smart Data menu is displayed only if one or more of the options have been set to ON by the clinician If Auto Appear is set to ON the Smart Data screens are displayed upon powering up of the device If Auto Appear is set to OFF Smart Data is displayed in the Results menu only Smart Data OFF Auto Appear Setting
6. Medical Electrical Equipment needs special precautions regarding EMC and needs to be installed and put into service according to EMC information provided in this document Warnings The VPAP should not be used adjacent to or stacked with other equipment If adjacent or stacked use is necessary the VPAP should be observed to verify normal operation in the configuration in which it will be used The use of accessories eg humidifiers other than those specified in this manual is not recommended They may result in increased emissions or decreased immunity of the VPAP System Specifications 37 Guidance and manufacturer s declaration electromagnetic immunity The VPAP is intended or the user of the VPA or use in the electromagnetic environment specified below The customer P should assure that it is used in such an environment Immunity test IEC60601 1 2 test level Compliance level Electromagnetic environment guidance Electrostatic discharge ESD 6 kV contact 6 kV contact Floors should be wood concrete or ceramic tile If IEC 61000 4 2 8 kV air 8 kV air floors are covered with synthetic material the relative humidity should be at least 30 Electrical fast 2 kV for power 2 kV Mains power quality should transient burst supply lines be that of a typical IEC 61000 4 4 commercial or hospital 1 kV for input Not Applicable environment output lines Surge 1 kV differe
7. System 7 Attaching a HumidAire 2i Humidifier Please refer to the illustrations in section E of the illustration sheet The HumidAire 2i attaches to the front of the VPAP to provide heated humidification No other accessories are required for its use The VPAP automatically detects the presence of the HumidAire 2i No menu changes are required Please refer to the HumidAire 2i User s Manual for details Attaching a HumidAire 2iC Humidifier Please refer to the illustrations in section F of the illustration sheet The HumidAire 2iC attaches to the front of a VPAP unit to provide passover humidification No other accessories are required for its use Please refer to the HumidAire 2iC User s Manual for details Note You must activate the humidifier option in the menus if you are using a HumidAire HumidAire 2iC or Passover humidifier Attaching a HumidAire Humidifier Please refer to the illustrations in section G of the illustration sheet Medium size 21 air tubing is a necessary accessory for connecting the VPAP unit to the HumidAire humidifier To set up the VPAP with the HumidAire 1 Fill the HumidAire with water as described in the humidifier manual 2 Place the filled water chamber inside the HumidAire Connect the medium 21 air tubing to the right connector port and the long air tubing 6 6 or 9 10 to the left connector port on the humidifier G 1 Close the Humidhire lid 3 Place the VPAP on top of the HumidAire G 2 Do
8. adapter that enables it to operate in other countries It will operate on power supplies of 100 240V and 50 60Hz No special adjustment is necessary but you may need a plug adapter for the power outlet Helpful Hints 29 30 Using a Battery and an Inverter Your VPAP without a humidifier can be powered by a battery using an inverter We recommend a 12V or 24V deep cycle battery and any CE or UL marked inverter with a continuous output power rating of 150W or higher For further details including use with humidifiers please refer to the VPAP Ill Series Battery Power Guide Troubleshooting If there is a problem try the following suggestions If the problem cannot be solved contact your equipment supplier or ResMed Do not attempt to open the unit Problem No display Possible Cause Power not connected or switch at back is not on Solution Ensure the power cable is connected and that the switch at the back of the unit is in the ON position Insufficient air delivered from the VPARP Ramp Time is in use Air filter is dirty Air tubing is kinked or punctured Air tubing not connected properly ask and headgear not positioned correctly Plug s missing from access port s on mask Pressure required for treatment may have changed Wait for air pressure to build up Replace air filter Straighten or replace tubing Check air tubing Adjust position of mask and headgear
9. advice The VPAP System Please refer to the illustrations in section A of the illustration sheet Please identify and familiarize yourself with the following components of the VPAP unit VPAP front view A 1 VPAP rear view A 2 Power cord A 3 Carry bag A 4 6 6 2 m air tubing A 5 WARNING Do not connect any device to the auxiliary port Although your health care provider may connect specially designed devices to the auxiliary port of the VPAP unit connection of other devices could result in injury or damage to the unit In the home environment the only device that may be connected to the communications port is a modem that is locally approved Locally approved modems may also be connected in the clinical environment In the clinical environment any PC that is used with the VPAP system must be at least 5 1 5 m away from or at least 8 2 5 m above the patient It must also comply with IEC 60950 or equivalent Masks You will also need a ResMed mask system supplied separately The following ResMed mask systems are recommended for use with the VPAP Nasal Masks Ultra Mirage Nasal Mask Mirage Nasal Mask Mirage Activa Nasal Mask Mirage Vista Nasal Mask Modular Nasal Mask Full Face Masks Mirage Full Face Mask Mirage Full Face Mask Series 2 Ultra Mirage Full Face Mask To select the appropriate setting for your mask see Settings for Mask Types on page 23 Th
10. 6 Other designs pending VPAP Activa HumidAire HumidAire 2i Mirage SmartStart Smart Data Ultra Mirage and Vista are trademarks of ResMed Ltd and VPAP Activa HumidAire HumidAire 2i Mirage SmartStart Ultra Mirage and Vista are registered in U S Patent and Trademark Office 2005 ResMed Ltd Contents Introduction User Owner Responsibilitv Medical Information What the VPAP lll and VPAP III ST Are Intended For Tell Your Doctor If Warnings Cautions The VPAP System risas Bee Masks Humidifiers Accessories Setting up the VPAP System Setting Up The VPAP Attaching a Humiditier Using the LCD Screen and Keypad Starting Treatment u Sms Carnet ede als rene Es Stopping Treatment Using the HumidAire 2i Warm Up Feature Using the Mask Fitting Feature Cleaning and Maintenance Daily Cleaning Weekly Cleaning Periodic Cleaning Replacing the Air Filter Servicing How to Use the VPAP Menus Ramp Screen How to Use the Standard Menu How to Use the Detailed Menu if enabled by your clinician Menu Functions Detailed menu only Treatment Screens Helpful Hints 22 442242 ly bere Ay draws ade Troubleshooting versre haies een System Specifications Limited Warranty sn ee ee bee te eer ele ee Contents In
11. BPM 0 1 BPM Minute ventilation 0 6 60 L min ER 0 25 L min Results may be inaccurate in the presence of leaks The displayed values are estimates They are provided for trending purposes only Note The manufacturer reserves the right to change these specifications without notice Symbols which appear on the product N Attention consult accompanving documents Class Il equipment Y Type CF equipment Drip Proof Start Stop or Mask Fit Guidance and Manufacturer s Declaration Electromagnetic Emissions and Immunity Guidance and manufacturer s declaration electromagnetic emissions The VPAP is intended for use in the electromagnetic environment specified below The customer or the user of the VPAP should assure that it is used in such an environment Electromagnetic environment Emissions test Compliance i guidance RF emissions CISPRTI Group 1 The VPAP uses RF energy only for its internal function Therefore its RF emissions are verv low and are not likelv to cause anv interference in nearbv electronic equipment RF emissions CISPR 11 Class B The VPAP is suitable for use in all establishments including domestic Harmonic Emissions Class A establishments and those directly IEC 61000 3 2 connected to the public low voltage network that supplies buildings used Voltage Fluctuations Flicker Complies for domestic purposes Emissions IEC 61000 3 3
12. M radio broadcast and TV broadcast cannot be predicted heoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which he VPAP is used exceeds the applicable RF compliance level above the VPAP should be observed to verify operation If abnormal performance is observed additional measures may be necessary such as b Over the frequency range 150 kHz to 80 MHz field strengths should be less than 10 V m System Specifications 39 40 Recommended separation distances between portable and mobile RF communications equipment and the VPAP The VPAP is intended for use in an environment in which radiated RF disturbances are controlled The customer or the user of the VPAP can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the VPAP as recommended below according to the maximum output power of the communications equipment Separation distance according to frequency of transmitter m Rated maximum output 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz power of transmitter Ww d 1 17 VP d 0 35 VP d 0 35 VP 0 01 0 17 0 04 0 04 0 1 0 37 0 11 0 11 1 1 17 0 35 0 35 10 3 69 1 11 1 11 100 11 70 3 50 3 50 For transmitters rated at a maximum output power not listed abov
13. Options ON OFF Selects the language the VPAP uses for all its display text English is the default language Language English English German French Italian Spanish Portuguese Swedish Dutch Servicing Menu Table 6 Servicing Menu Function Function Description Setting Options Serial Displays the serial number for the VPAR View only Number SN Printed Displays the printed circuit board View only Circuit Board number or NONE if not available PCB Software Displays the current software version View only installed in the VPAP This item also appears in the Standard Menu How to Use the VPAP Menus 25 26 Treatment Screens After starting treatment you can display one of the treatment screens below Press the Up Down key to switch between views Ramping indicator Set pressure s Treatment mode S RAMP 8 0 16 6 S gt gt gt gt gt exit Trigger indicator Pressure bar graph Figure 3 Treatment screen 1 Respiratory rate Tidal volume Leak Minute ventilation LK 24L min RR 12 MV 12 0 VT 1000 Figure 4 Treatment screen 2 Cycle indicator TiMn C TiMx Set IPAP Max Measured I E ratio Trigger indicator S C TiMx 2 0 Ti 155 1 1 25 Measured inspiration time Figure 5 Treatment screen 3 The treatment screens contain the following information Treatment mode Mode of treatment set by yo
14. RESMED VPAP III amp Ill ST User Manual 248128 1 VPAP Ill amp Ill ST User Manual USA 248128 1 05 08 Global leaders in sleep and respiratory medicine www myresmed com RESMED HUMIDIFIERS SETTING UPTHE VPAP HUMIDAIRE 2i AND VPAP VPAP III amp II ST Illustrations Component of 248128 1 A SYSTEM COMPONENTS Docking HumidAire 2i 2 HumidAire 2iC Le station Handle Ke SE Water LCD screen X I I chamber Control panel E Removable Air outlet front cover o 2 ei D wn o cc Lo fe S A HUMIDAIRE 2iC AND VPAP 3 HumidAire 4 ResMed Passover Air filter cover 2005 ResMed Ltd Power switch Serial communications Power socket port 9 pin Docking station Water chamber 9 10 3 m 21 52 cm 6 6 2 m O 2005 ResMed Ltd O 2005 ResMed Ltd O 2005 ResMed Ltd O 2005 ResMed Ltd G ATTACHING A HUMIDAIRE HUMIDIFIER H ATTACHING A PASSOVER HUMIDIFIER REPLACING THE AIR FILTER RESMED VPAP III amp III ST User Manual Manufactured by ResMed Ltd 1 Elizabeth MacArthur Drive Bella Vista NSW 2153 Australia Tel 61 2 8884 1000 or 1 800 658 189 toll free Fax 61 2 8883 3114 Email reception resmed com au Distributed by ResMed Corp 14040 Danielson Street Poway CA 92064 6857 USA Tel 1 858 746 2400 or 1 800 424 0737 toll free Fax 1 858 746 2900 Email reception resmed com ResMed UK Limited 65 Milton Park Abing
15. Replace plug s See your clinician to adjust the pressure The VPAP does not start when you breathe into the mask Power cord not connected properly Power outlet may be faulty The VPAP unit not switched on SmartStart not on Mask Alarm has been enabled SmartStart has automatically been disabled Connect power cord firmly at both ends Try another power outlet Switch power switch at rear of the VPAP to ON Enable SmartStart Disable Mask Alarm to enable SmartStart Troubleshooting 31 32 Problem Possible Cause Breath is not deep enough to trigger SmartStart There is excessive leak Solution Take a deep breath in and out through the mask Adjust position of mask and headgear Plugs may be missing from ports on mask Replace them Air tubing not connected properly Connect firmly at both ends Air tubing kinked or punctured Straighten or replace VPAP unit does not stop when you remove your mask SmartStart Stop is disabled Use of an Ultra Mirage Full Face Mask Enable SmartStart Stop SmartStop does not work with a full face mask SmartStart is enabled but the flow generator does not stop automatically when you remove your mask Incompatible humidifier or mask system being used Use only equipment as recommended and supplied by ResMed Display error message Check tube Key if done The air tubing is loose Check tha
16. Using the Mask Fitting feature 14 Using the Menus 19 w Warnings Related to Treatment 3 Weekly Cleaning 17 Weight 35
17. air filter The air filter is not washable or reusable Note The air filter should be inspected once a month Servicing This product VPAP IIIMVPAP III ST should be inspected by an authorized ResMed service center 5 years from the date of manufacture Prior to this the device is intended to provide safe and reliable operation provided that it is operated and maintained in accordance with the instructions provided by ResMed Applicable ResMed warranty details are provided with the device at the time of original supply Of course as with all electrical devices if any irregularity becomes apparent you should exercise caution and have the device inspected by an authorized ResMed service center If you feel that your unit is not performing properly see Troubleshooting on page 31 CAUTION Inspection and repair should only be performed by an authorized agent Under no circumstances should you attempt to service or repair the flow generator yourself How to Use the VPAP Menus The VPAP unit provides a set of functions arranged in menus and submenus Via the LCD screen the menus and submenus allow you to view and change the settings for a particular function You can access the menus regardless of whether the VPAP is in standby mode or delivering therapy Your clinician has preset the menu to either a standard view or a detailed view Both of these menus are explained below When the VPAP is turned on a Welcome screen is displayed
18. ast three seconds and treatment will begin immediately If you press the Front key for less than three seconds the unit will return to standby mode the VPAP or Ramp screen is displayed Table 1 Definitions of Mask Fit Star Rating Star rating KKKEK Definition Excellent KHER Very good KKK Good XX Adjust mask ka Adjust mask HIGH LEAK Adjust mask Starting Treatment 15 Cleaning and Maintenance You should regularly carry out the cleaning and maintenance described in this section Daily Cleaning Mask Clean the mask according to the instructions supplied with the mask Air tubing Disconnect the air tubing from the VPAP unit and humidifier if used and hang the tubing and mask in a clean dry place until next use CAUTION Do not hang the air tubing in direct sunlight as the tubing may harden over time and eventually crack Humidifier If you are using a humidifier clean it according to the instructions in the humidifier user manual Weekly Cleaning 1 Remove the air tubing from the VPAP unit and the mask 2 Wash the air tubing in warm water using mild detergent Rinse thoroughly hang and allow to dry 3 Before next use assemble the mask and headgear according to the user instructions 4 Reconnect the air tubing to the air outlet and mask CAUTION Do not use bleach chlorine alcohol or aromatic based solutions including all scented oils moisturizi
19. atment will begin After starting treatment you can display one of the treatment screens described in Treatment Screens on page 26 Ramp time Ramp time is a feature which can be enabled by your clinician If you have difficulty falling asleep with full pressure select a ramp time The airflow will start very gently while you fall asleep The pressure will slowly increase to full operating pressure over the selected ramp time The clinician has set a maximum ramp time you may select any value up to the maximum To select a ramp time see Ramp Screen on page 19 Starting Treatment 13 Stopping Treatment To stop treatment at any time remove your mask and press the Front key or if your clinician has enabled the SmartStart function simply remove your mask and treatment will end SmartStop is not applicable with the Mir Full mask setting Using the HumidAire 2i Warm Up Feature If using a HumidAire 2i with the VPAP you can use the Warm Up feature to pre heat the water in the humidifier prior to starting treatment After stopping treatment the VPAP will continue to blow air gently to assist cooling of the heater plate See the HumidAire 2i User s Manual for further details Using the Mask Fitting Feature The VPAP Mask Fitting feature can be used to help you fit your mask properly The mask fitting feature delivers air pressure for a three minute period prior to starting treatment for checking and adjusting your ma
20. don Oxfordshire OX14 4RX UK Tel 44 1235 862 997 Fax 44 1235 831 336 Email reception resmed co uk ResMed Asia Pacific Ltd 97 Waterloo Road North Ryde NSW 2113 Australia Tel 61 2 9886 5000 or 1 800 991 900 toll free Fax 61 2 9889 1471 Email reception resmed com au ResMed Austria GmbH Purtscherstra e 18 9500 Villach sterreich Tel 43 4242 430 830 Fax 43 4242 430 830 4 Email reception resmed at ResMed BV Nieuwe Parklaan 86 2587 BV Den Haag Nederland Tel 31 70 358 6263 Fax 31 70 358 4333 Email receptiondh resmed nl ResMed Finland Niittykatu 6 FIN 02200 ESPOO Suomi Puh 358 9 8676820 Faksi 358 9 86768222 S hk posti reception resmed fi ResMed GmbH amp Co KG Fraunhoferstra e 16 82152 Martinsried Deutschland Tel 49 0 89 99 01 00 Fax 49 0 89 99 01 10 55 Email reception resmed de ResMed Hong Kong Limited Room 1714 Miramar Tower 132 134 Nathan Road Tsim Sha Tsui Hong Kong Tel 852 2366 0707 Fax 852 2366 4546 Email reception resmed com hk ResMed Japan Nihonbashi Hisamatsu Bldg 4F 2 28 1 Nihonbashi Hamacho Chuo Ku Tokyo 103 0007 Japan Tel 81 3 3662 5056 Fax 81 3 3662 5040 ResMed Malaysia Sdn Bhd Suite E 10 20 Plaza Mon t Kiara No 2 Jalan 1 70C Mon t Kiara 50480 Kuala Lumpur Malaysia Tel 60 3 6201 7177 Fax 60 3 6201 2177 Email reception resmed com my ResMed NZ Ltd PO Box 51 048 Pakuranga Auckland New Zealand Tel 64 274 737 633 Fax 64 9 239 0193 Email reception resmed co
21. e the recommended separation distance d in meters m can be determined using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Limited Warranty ResMed warrants that your ResMed product shall be free from defects in material and workmanship for the period specified below from the date of purchase by the initial consumer This warranty is not transferable Product Warranty Period ResMed humidifiers ResControl ResLink ResTraxx 1 Year ResMed flow generators 2 Years Accessories mask systems including mask frame 90 Days cushion headgear and tubing Excludes single use devices Note Some models are not available in all regions If the product fails under conditions of normal use ResMed will repair or replace at its option the defective product or any of its components This Limited Warranty does not cover a any damage caused as a result of improper use abuse modification or alteration of the product b repairs carried out by any service organization that has not been expressly authorized by ResMed to
22. e Performs the function indicated by the guiding text displayed above it on the LCD screen Guiding text includes menu enter change and apply Right red e Performs the function indicated by the guiding text displayed above it on the LCD screen Guiding text e includes exit and cancel The keypad backlight is on at all times when the VPAP is powered Setting up the VPAP System 11 Starting Treatment The VPAP unit should be assembled beside your bed with the air tubing and mask system connected See Setting Up The VPAP on page 7 1 Turn the main power switch at the back of the unit to on I Main LI power switch Ea EJ When the VPAP is turned on a welcome message is displaved on the LCD screen The VPAP or Ramp screen then appears Note If you have the HumidAire 2i attached see Using the HumidAire 2i Warm Up Feature on page 14 2 Fityour mask as described in the mask user instructions 3 Lie down and arrange the air tubing so that it is free to move if you turn in your sleep CAUTION Do not leave long lengths of air tubing around the top of your bed It could twist around your head or neck while you are sleeping Make sure the area around the flow generator is dry and clean It should also be clear of bedding clothes and other potential blockages 4 To start treatment press the Front key or if your clinician has enabled the SmartStart function simply breathe into the mask and tre
23. e VPAP System 5 Notes e ResMed VPAP devices have been designed and manufactured to provide optimum performance using ResMed vented mask systems While other vented mask systems may be used performance and data outputs may be affected To select an appropriate setting for another mask system find the closest match to a ResMed mask in Table 3 on page 23 Not all masks are available in all regions Humidifiers Please refer to the illustrations in section B of the illustration sheet A humidifier may be required if you are experiencing dryness of the nose throat or mouth The VPAP is compatible for use with the following humidifiers HumidAire 2i heated humidifier B 1 e HumidAire 2iC passover humidifier B 2 HumidAire heated humidifier B 3 ResMed Passover humidifier B 4 WARNING Only the HumidAire 2i HumidAire 2iC HumidAire heated humidifier and the ResMed Passover are compatible for use with the VPAP Please refer to Warnings on page 2 Accessories Please refer to the illustrations in section C of the illustration sheet The following accessories may be purchased separately 9 10 3 m air tubing C 1 Medium 21 52 cm air tubing for the HumidAire and ResMed Passover humidifiers C 2 Note ResMed regularly releases new products Please check our website at lt www resmed com gt Setting up the VPAP System Please refer to the illustrations in section D of the illustration sheet
24. he Detailed Menu if enabled by your clinician The detailed menu allows you to view and change settings such as mask type tube length and the humidifier used You can also view the serial number and current software version of your VPAP Figure 2 summarizes the VPAP detailed menu series VPAP screen Ramp screen RESMED VPAP III RAMP 20min OFF 5 10 15 20 25 menu menu f 30 35 40 45 min SETTINGS enter 4 exit MASK ULTRA MIRAGE MIR FULL change 4 exit STANDARD ULTRA TUBE LENGTH 2m change 1 exit 2m 3m NONE PASSOVER HUMIDAIRE HUMID NONE If the HumidAire 2i is used the above change 1 exit options do not appear and H2i is displayed SMARTSTART OFF change exit ON OFF MASK ALARM OFF ON OFF change exit i I RESULTS l I enter exit l x MASK FIT These menus appear good 1 exit I only if at least one I Bis He ox Smart Data option has I I been enabled by the I I clinician I OPTIONS enter exit 1 I SMART DATA l l enter J exit favtoappeanorF l change exit l ENGLISH GERMAN FRENCH LANGUAGE ENGLISH ITALIAN SPANISH PORTUGUESE SWEDISH DUTCH change f exit SERVICING enter f exit SN 123456789123 i 456789 1 exit View only PCB NONE CD a menu item 1 View only EE represents a submenu item SW en TA View only function MASK MIRAGE setting op
25. ily Cleaning 17 definitions 1 Detailed Menu 20 21 Dimensions 35 Dryness 29 Dynamic pressure characteristics 35 E Electromagnetic Compatibility 35 Environmental Conditions 35 Error Messages 32 F Front Key 10 G Glossary of Symbols 36 H Helpful Hints 29 High Leak Message 23 Housing Construction 35 how to use the VPAP 7 HumidAire 8 HumidAire 2i 8 HumidAire 2iC 8 Humidifier 6 cleaning 17 Humidifier Use 7 l IEC 60601 1 Classifications 36 International Use 29 inverter 30 K keypad 10 Keys functions 10 L LCD screen 10 Left Key 11 M Mask Alarm 23 Mask Fitting 29 mask settings 23 mask types 23 Mask Fit Star Rating definitions 15 Mask Fitting Feature 14 Masks 5 maximum flow 35 Medical Information 1 Menu Functions 22 menu type 19 Menus using the VPAP 19 Mouth Leaks 29 N Nasal Irritation 29 O Operating Instructions 13 Options Menu 25 P Passover 9 periodic cleaning 17 Power Supplv 35 R Ramp Screen 19 Ramp time 19 Replacing the Air Filter 18 Responsibility user owner 1 Results Menu 24 Index 43 44 Right Key 11 Runny or Blocked Nose 29 S Servicing 18 Servicing Menu 25 setting up 7 Settings Menu 22 Side Effects 4 SmartStart 23 Standard Menu 20 Starting Treatment 13 Stopping Treatment 14 System Specifications 35 T Travelling 29 treatment screen 26 Troubleshooting 31 U Up Down Key 10 Used time screen 19 User Owner Responsibility 1
26. ith EN 1281 1 1997 Anaesthetic amp Respiratory Equipment Conical Connectors Pressure measurement Internally mounted pressure transducer Flow measurement Internally mounted flow transducer Power Supply Input range 100 240V 50 60Hz 40VA typical power consumption lt 100VA maximum power consumption Housing Construction Flame retardant engineering thermoplastic Environmental Conditions Operating Temperature 41 F 5 C to 104 F 40 C Operating Humidity 10 95 non condensing Storage and Transport Temperature 4 F 20 C to 140 F 60 C Storage and Transport Humidity 10 95 non condensing Electromagnetic Compatibility Product complies with all applicable electromagnetic compatibility requirements EMC according to IEC60601 1 2 for residential commercial and light industry environments For further details see Guidance and Manufacturer s Declaration Electromagnetic Emissions and Immunity on page 37 Air Filter Two layered powder bonded polyester non woven fiber System Specifications 35 36 Air Tubing Flexible plastic 6 6 2 m or 9 10 3 m length IEC 60601 1 Classifications Class II double insulation Type CF Table 7 Displayed values Value Range Accuracy Pa A Pressure sensor at air outlet Pressure 5 to 30 cm H20 0 5 cm H20 0 1 cm H20 Flow sensor in flow generator Leak 0 120 L min m 1 L min Tidal volume 100 3000 mL i 1 mL Respiratorv rate 6 60 BPM 0 5
27. mothorax or pneumomediastinum e severe heart failure low blood pressure or dehydration Introduction 1 surgery to the brain middle or inner ear pituitary gland or sinuses respiratory distress syndrome middle ear infection or perforated ear drum severe nosebleed Warnings CPAP or bilevel therapy should be used with caution if you have any of the following conditions e respiratory failure e cavities or cysts in the lung or previous history of pneumothorax previous history of severe nosebleed e sinus infection Tell your doctor if you have any of these conditions Your doctor will advise you whether the likely benefits of CPAP or bilevel therapy outweigh the expected risks Special care should be exercised if you are dehydrated or may become dehydrated for example as a result of fluid restriction or diuretic therapy including changes in therapy Discontinue therapy and seek medical advice if during therapy or when you start therapy each night you feel faint or light headed The following are general warnings that pertain to your use of a VPAP unit Specific warnings appear next to the relevant instructions in the manual WARNING This is NOT a life support device lt may stop operating with power failure or if a fault occurs in the unit The air flow for breathing produced by this device can be as much as 11 F 6 C higher than the temperature of the room Caution should be exercised if the room
28. ng or antibacterial soaps to clean the air tubing or the VPAP These solutions may cause hardening and reduce the life of the product Do not hang the air tubing in direct sunlight as the tubing may harden over time and eventually crack Periodic Cleaning 1 Clean the exterior of the VPAP unit with a damp cloth and mild liquid soap 2 Inspect the air filter to check if it is blocked by dirt or contains holes See Replacing the Air Filter on page 18 Cleaning and Maintenance 17 WARNING Beware of electric shock Do not immerse the flow generator or power cord in water Always unplug the flow generator before cleaning and be sure that it is dry before reconnecting CAUTION Do not attempt to open the VPAP There are no user serviceable parts inside Repairs and internal servicing should only be performed by an authorized service agent Replacing the Air Filter Please refer to the illustrations in section A of the illustration sheet Inspect the air filter every month to check if it is blocked by dirt or contains holes With normal use of a VPAP unit the air filter needs to be replaced every six months or more often if your unit is in a dusty environment To replace the air filter 1 Remove the air filter cover at the back of the VPAP I 1 2 Remove and discard the old air filter 3 Insert a new filter with the blue tinted side facing out I 2 4 Replace the air filter cover I 3 WARNING Do not wash the
29. not place the VPAP unit underneath the humidifier This is to avoid water spilling into the unit 4 Connect the free end of the medium air tubing to the air outlet of the VPAP G 3 5 Connect the mask system to the free end of the long air tubing The final assembly should look like figure G 4 6 Plug the HumidAire power cord into a power outlet 7 If the VPAP is not already plugged in see Step 2 on page 7 WARNING Make sure that the power cord and plug are in good condition and the equipment is not damaged 8 Navigate to the humidifier setting if available in the VPAP menu and select HUMIDAIRE See How to Use the Detailed Menu if enabled by your Clinician on page 20 The VPAP is now ready for use with the HumidAire To start treatment see Starting Treatment on page 13 Attaching a Passover Humidifier Please refer to the illustrations in section H of the illustration sheet Medium size 21 air tubing is a necessary accessory for connecting the VPAP unit to the ResMed Passover humidifier To set up the VPAP with the ResMed Passover 1 Fill the Passover with water as described in the humidifier manual 2 Connect the medium 21 air tubing to the right connector port and the long air tubing 6 6 or 9 10 to the left connector port on the humidifier H 1 3 Place the VPAP on top of the Passover H 2 Do not place the VPAP unit underneath the humidifier This is to avoid water spilling into the unit
30. ntial 1 kV differential Mains power quality should IEC 61000 4 5 mode mode be that of a typical 2 kV common mode 2 kV common mode commercial or hospital environment Voltage dips short lt 5 U lt 12V Mains power quality should interruptions and gt 95 dip in Ut gt 95 dip in 240V be that of a typical voltage variations on or 0 5 cycle or 0 5 cycle commercial or hospital power supply input environment lines 40 U 96V If the user of the VPAP IEC 61000 4 11 60 dip in Ut 60 dip in 240V requires continued or 5 cycles or 5 cycles operation during power mains interruptions it is 70 U 168V recommended that the 30 dip in Ut 30 dip in 240V VPAP be powered from an or 25 cycles or 25 cycles uninterruptible power source lt 5 U lt 12V gt 95 dip in Ut gt 95 dip in 240V or 5 sec or 5 sec Power frequency 3 A m 3 A m Power frequency magnetic 50 60 Hz magnetic field IEC 61000 4 8 fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE Ut is the a c mains voltage prior to application of the test level Continued next page Guidance and manufacturer s declaration electromagnetic immunity Continued The VPAP is intended for use in the electromagnetic environment specified below The customer or the hould assure that it is used in such an environment user of the VPAP s Immunity test
31. nz ResMed SA Parc de la Bandonni re 2 rue Maurice Audibert 69800 Saint Priest France T l 33 0 4 37 251 251 Fax 33 0 4 37 251 260 Email reception resmed fr ResMed Singapore Pte Ltd 238A Thomson Road 12 03 04 Novena Square Tower A Singapore 307684 Tel 65 6284 7177 Fax 65 6284 7787 Email reception resmed com sg ResMed Spain SL C Arturo Soria 245 28033 Madrid Espana Tel 34 93 5908154 Fax 34 93 5908153 Email angelo resmed es ResMed Sweden AB Industrigatan 2 S 461 37 Trollhattan Sverige Tel 46 520 420 110 Fax 46 520 397 15 Email reception resmed se Labhardt AG Thannerstrasse 57 CH 4054 Basel Schweiz Tel 41 061 307 9711 Fax 41 061 307 9722 Email info labhardt ch US DESIGNATED AGENT ResMed Corp EU AUTHORIZED REPRESENTATIVE ResMed UK Ltd Internet www myresmed com Protected by patents AU 697652 AU 699726 AU 713679 EP 0661071 EP 0858352 US 4944310 US 5199424 US 5522382 US 6213119 US 6240921 US 6705315 Other patents pending Protected by design registrations AU 147283 AU 147335 AU 147336 CH 128 709 CH 128 710 CH 128 711 CH 128 712 DE 40201723 DE 40202007 DE 40202008 DE 40202020 ES 153514 ES 153515 ES 153516 ES 153518 ES 156135 ES 156136 FR 02 1407 GB 3001791 GB 3001819 GB 3001820 GB 3001821 JP 1164087 JP 1164265 JP 1164266 JP 1164267 JP 3638613 SE 75598 SE 75599 SE 75600 SE 75715 US D467335 US D468011 US D476077 US D477868 US D487311 US D50379
32. perform such repairs c any damage or contamination due to cigarette pipe cigar or other smoke d any damage caused by water being spilled on or into a flow generator Warranty is void on product sold or resold outside the region of original purchase Warranty claims on defective product must be made by the initial consumer at the point of purchase This warranty is in lieu of all other express or implied warranties including any implied warranty of merchantability or fitness for a particular purpose Some regions or states do not allow limitations on how long an implied warranty lasts so the above limitation may not apply to you ResMed shall not be responsible for any incidental or consequential damages claimed to have occurred as a result of the sale installation or use of any ResMed product Some regions or states do not allow the exclusion or limitation of incidental or consequential damages so the above limitation may not apply to you This warranty gives you specific legal rights and you may also have other rights which vary from region to region For further information on your warranty rights contact your local ResMed dealer or ResMed office R001 307 2 05 06 Limited Warranty 41 42 Index A Accessories 6 Air filter 18 35 air tubing 36 cleaning 17 B Back light LCD and Keypad 10 battery use 30 C cautions 4 cleaning daily 17 periodic 17 weekly 17 Cleaning and Maintenance 17 cleaning mask 17 D Da
33. r respiratory tract middle ear or sinuses contact your clinician before continuing your CPAP or bilevel treatment You may be advised to stop treatment until the infection has cleared If you continue with treatment during an infection be sure to clean your mask and tubing after every use Medical Information 3 Cautions The following are general cautions Specific cautions appear next to the relevant instructions in the manual CAUTION Do not open the VPAP case There are no user serviceable parts inside Repairs and internal servicing should only be performed by an authorized service agent Possible Side Effects The VPAP flow generator is designed to help you have a good night s sleep However you need to be aware of possible problems that may arise during CPAP or bilevel treatment WARNING Consult your clinician immediately if you experience any of the following symptoms during your CPAP or bilevel treatment headache middle ear or sinus discomfort chest pain dryness of the nose mouth or throat feeling bloated due to air swallowing air continually leaking out of the mouth while sleeping e recurrence of any sleep apnea symptoms while on CPAP or bilevel Skin irritation may occur from sensitivity to the mask materials or from excessively tight headgear straps A correctly fitted mask and appropriately adjusted straps will often prevent skin irritation If problems persist contact your clinician for
34. sk fit to minimize leaks If a Ramp time is selected the mask can be adjusted at a pressure closer to the prescribed pressure To use the mask fitting feature 1 Fit your mask as described in the user instructions 2 Hold down the Front key for at least three seconds until air pressure delivery starts The following display will appear on the LCD screen indicating that the Mask Fitting feature is in operation The flow generator will ramp to the Mask Fit pressure and will remain at this pressure for three minutes A Mask Fit star rating is also displayed See Definitions of Mask Fit Star Rating on page 15 Mask Fit KKKKK Mask Fit Star rating excelnt RESMED Notes The Mask Fit star rating display disappears after three minutes The Mask Fitting feature can only be started from the VPAP or Ramp screen The Mask Fit pressure is the set treatment pressure or 10 cm H30 whichever is greater 3 Adjust your mask mask cushion and headgear until you have a secure and comfortable fit Once you have a secure and comfortable fit check your Mask Fit star rating on the LCD screen Definitions of the Mask Fit star ratings are presented in Table 1 Note If there is another person nearby to check your Mask Fit star rating you can adjust your mask mask cushion and headgear while lying down 4 After three minutes treatment will begin If you do not wish to wait three minutes hold down the Front key for at le
35. t the air tubing is connected securely to your mask and the air outlet on the front of the VPAR To clear the error message press any key on the VPAP keypad Displays error message SYSTEM ERROR Call service Component failure Return your VPAP for servicing Problem Excessive motor noise Possible Cause Component failure Solution Return your unit for servicing Display error message High leak in last session You have experienced excessively high leak levels during the night Check that your air tubing is connected properly and that your mask does not leak excessively Use the mask fitting feature to help you to fit your mask properly If this message appears again contact your clinician Troubleshooting 33 34 System Specifications Dynamic pressure characteristics IPAP 3 cm H20 to 25 cm H20 measured at the end of standard 6 6 air tubing EPAP 3 cm H20 to 25 cm H20 measured at the end of standard 6 6 air tubing CPAP 4 to 20 cm H20 measured at the end of standard 6 6 air tubing Maximum single fault pressure 40 cm H20 Maximum flow CPAP mode measured at the end of standard 6 6 air tubing Pressure Flow cm H O L min 10 200 15 170 20 150 Sound pressure level lt 30 dB tested in accordance with the requirements of ISO 17510 1 2002 Dimensions L x W x H 10 6 x 9 1 x 5 6 Weight 5 lb Air outlet 22 mm taper compatible w
36. tails Tube Length 2m Selects the length of air tubing 2m 3m 6 6 connecting vour mask to the 6 6 9 10 VPAP 22 Function Default Function Description Setting Options Humidifier NONE Selects the type of humidifier to NONE PASSOVER be used with the VPAP HUMIDAIRE If the HumidAire 2i is used the above setting options do not appear and H2i is displayed SmartStart OFF Turns the SmartStart function on ON OFF or off See SmartStart on page 23 Mask Alarm ON Turns the Mask Alarm signal on ON OFF VPAP III ST or off OFF If enabled the Mask Alarm VPAP III feature will alert you when a high mask leak is detected An audible tone will sound and a high leak message will appear on the LCD screen SmartStart The VPAP has a function called SmartStart which can be enabled by your clinician If SmartStart is enabled VPAP will start automatically when you breathe into the mask and will stop automatically when you take your mask off This means you do not have to press the Front key to begin or end treatment Note If you select Mir Full as the mask option SmartStop is automatically disabled SmartStart may not work with an Ultra Mirage Full Face Mask due to safety features of the mask When Mask Alarm is set to ON SmartStart Stop automatically reverts to OFF SmartStop cannot be used with Mask Alarm because if a high leak occurs SmartStop will stop treatment before the Mask
37. temperature is warmer than 90 F 32 C The VPAP unit should only be used with masks and connectors recommended by ResMed or by your physician or respiratory therapist A mask should not be used unless the VPAP unit is turned on and operating properly The vent hole or holes associated with the mask should never be blocked Explanation The VPAP unit is intended to be used with special masks or connectors which have vent holes to allow continuous flow of air out of the mask When the device is turned on and functioning properly new air from the device flushes the exhaled air out through the mask vent holes However when the device is not operating insufficient fresh air will be provided through the mask and the exhaled air may be Ports may be incorporated in the mask or in connectors that are near the mask rebreathed Rebreathing of exhaled air for longer than several minutes can in some circumstances lead to suffocation This applies to most models of CPAP or bilevel devices The VPAP unit should only be connected to the components humidifiers or accessories specified in this manual Connection of other items may result in injury or damage to the VPAP unit At low pressures the flow through the exhalation ports of your mask may not clear all exhaled gas from the tubing Some rebreathing may occur Explosion hazard do not use in the vicinity of flammable anesthetics If oxygen is used with this device
38. the oxygen flow must be turned off when the device is not operating Explanation of the warning When the device is not in operation and the oxygen flow is left on oxygen delivered into the ventilator tubing may accumulate within the device enclosure Oxygen accumulated in the device enclosure will create a risk of fire This warning applies to most types of flow generators Oxygen supports combustion Oxygen should not be used while smoking or in the presence of an open flame Always ensure air flow is being generated by the device before the oxygen supply is turned on Always turn the oxygen supply off before stopping the air flow from the device Note At a fixed rate of supplemental oxygen flow the inhaled oxygen concentration will vary depending on where the oxygen is introduced pressure settings patient breathing pattern mask selection and leak rate This applies to most types of flow generators Warnings related to treatment WARNING 25 If you stop your CPAP or bilevel treatment your sleep apnea will return immediately Always consult your clinician if you expect to be in a situation where you cannot use your VPAP unit If you are admitted to a hospital or prescribed any other form of medical treatment always inform the medical staff that you are being treated with CPAP or bilevel It is also important to contact the clinician who is treating you for sleep apnea If you experience an infection of the uppe
39. tion change gt exit Setting options bold text 2m 3m indicates default setting Figure 2 VPAP Detailed Menu Series if enabled by your clinician How to Use the VPAP Menus 21 To access the VPAP menus Press the Left key menu while the VPAP or Ramp screen is displayed To scroll through items within a menu or submenu Press the Up Down key To enter a submenu Press the Left key enter To change a setting option for a function 1 Press the Left key change 2 Press the Up Down key until the desired setting option appears 3 Press the Left key apply to select the setting option To exit without changing options Press the Right key cancel To exit out of a menu or submenu Press the Right key exit Note You can return to the VPAP or Ramp screen at any time by holding the Right key for at least three seconds Menu Functions Detailed menu only The VPAP menu functions are Summarized in Tables 2 6 below with a brief description of what each function does and the available setting options To access these functions see How to Use the Detailed Menu if enabled by your clinician on page 20 Settings Menu The Settings Menu allows you to view and change certain operating features of the VPAP unit Table 2 Settings Menu Functions Function Default Function Description Setting Options Mask ULTRA Selects your mask type See Settings for Mask Types on page 23 for de
40. troduction The VPAP III and VPAP III ST are bilevel pressure support ventilators specifically designed for non invasive mask ventilation This user manual contains the information you need for the correct use of your VPAP User Owner Responsibility The user or owner of this system shall have sole responsibility and liability for any injury to persons or damage to property resulting from operation which is not in accordance with the operating instructions supplied maintenance or modifications carried out unless in accordance with authorized instructions and by authorized persons Please read this manual carefully before use This manual contains special terms and icons that appear in the margins to draw your attention to specific and important information e Warning alerts you to possible injury e Caution explains special measures for the safe and effective use of the device Note is an informative or helpful note Medical Information What the VPAP Ill and VPAP III ST Are Intended For The VPAP III and VPAP III ST systems are intended for the treatment of obstructive sleep apnea OSA in adult patients for home and hospital use CAUTION USA ONLY Federal law restricts this device to sale by or on the order of a physician Tell Your Doctor If You must tell your doctor and CPAP continuous positive airway pressure or bilevel therapy must not be used if you have any of the following conditions pneu
41. try to keep your mouth closed during treatment Air leaks from your mouth can decrease the effectiveness of your treatment If mouth leaks are a problem a full face mask or chin strap may help Contact your Clinician or equipment supplier for further details Mask Fitting The flow generator delivers the most effective treatment when the mask is well fitted and comfortable Treatment can be affected by leaks so it is important to eliminate any leaks that may arise If you have problems trying to get a comfortable mask fit contact your sleep clinic or equipment supplier You may benefit from a different size or style of mask You can also use the Mask Fitting feature to help you fit your mask properly See Using the Mask Fitting Feature on page 14 Before wearing your mask wash your face to remove excess facial oils This will allow a better fit and prolong the life of the mask cushion Nasal Irritation Dryness You may experience dryness of the nose mouth and or throat during the course of treatment especially during winter In many cases a humidifier may resolve this discomfort Contact your clinician for advice Runny or Blocked Nose You may experience sneezing and or a runny or blocked nose during the first few weeks of treatment In many cases nasal irritation can be resolved with a humidifier Consult your clinican for advice Travelling with the VPAP International Use Your VPAP flow generator has an internal power
42. ur clinician Options include CPAP Spontaneous Spontaneous Timed VPAP III ST and Timed VPAP III ST Ramping indicator Appears if the VPAP is in ramp mode This disappears once the ramp time has elapsed Set pressure s In CPAP mode this displays the set treatment pressure units centimeters of water In other modes it is exhalation and inhalation pressures units centimeters of water Trigger indicator How the VPAP changes the pressure when you are inhaling S Spontaneous indicates a patient triggered change and T Timed indicates a device triggered change Pressure bar graph Graphical display of the changing pressure Leak Current mask leak units liters per minute Respiratory rate Number of breaths per minute Minute ventilation Volume of air inhaled per minute units liters per minute It is the product of respiratory rate and tidal volume Tidal volume Volume of air inhaled per breath units milliliters per breath Cycle indicator How the VPAP changes the pressure when you are exhaling C indicates a patient cycled change TiMn and TiMx indicates a device cycled change Measured inspiration time The average inhalation time measured by the VPAP Set IPAP Max The maximum inhalation time set by your clinician Measured I E ratio The inhalation to exhalation ratio measured by the VPAP How to Use the VPAP Menus 27 28 Helpful Hints Starting out Mouth Leaks If using a nasal mask
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