Intelligent Backup Rate (Ibr); Configuring Ivaps; Adopting Recently Learnt Targets - ResMed Astral Series Clinical Manual

intelligent Backup Rate (iBR)

Instead of mandating a fixed backup rate, the intelligent Backup Rate (iBR) will shift automatically
between two limits.
During sustained apnoea, the iBR will adopt a pre-configured Target Patient Rate. This Target Patient
Rate defines the upper boundary for iBR. Set the Target Patient Rate to match the patient's average
spontaneous rate (unlike a traditional backup rate).
1. During spontaneous ventilation, the iBR adjusts to remain in the background, at two-thirds of the
Target Patient Rate. This 'background' backup rate is lower than a traditional (S)T rate, so gives the
patient maximum opportunity to spontaneously trigger.
2. When spontaneous triggering ceases (eg, at the onset of an apnoea/hypopnoea), the iBR adjusts
from its background frequency to its Target Patient Rate in iVAPS mode and adjusts quickest
(typically within 4 to 5 breaths) when ventilation is below the target ventilation.
3. A single spontaneous triggered breath resets the iBR to its background rate (two-thirds of Target
Patient Rate).

Configuring iVAPS

There are two ways in which you can configure iVAPS mode:
•
Adopting the recently learnt targets, from any vented mode (CPAP, (S)T or PAC)—learns the patient's
breathing pattern and calculates the target values automatically, or
• Entering the target values manually.

Adopting recently learnt targets

While ventilating the patient on the Vented mode of your choice (CPAP, (S)T or PAC), the patient's
resting ventilation is monitored, with the goal of learning the patient's Target Alveolar Ventilation (Target
Va) and Target Patient Rate (Target Pt Rate) in preparation for iVAPS mode.
After the final circuit configuration (includes patient's height, EPAP, appropriate mask settings and any
supplemental oxygen added) is achieved, follow the procedure below.
Over the last five minutes of ventilation, Tidal Volume and Respiratory Rate are recorded for each breath.
Target Va and Target Pt Rate are then calculated over those last five minutes. Ensure the patient remains
comfortable, breathing is stable and leak is minimised.
Note: iVAPS and AutoEPAP will only be initiated once Learn Target values are accepted.
Ventilation modes
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