PHILIPS Respironics OmniLab Advanced + Clinical Manual page 16

A-Flex (C-Flex+) Comfort Feature
The device is equipped with a special comfort feature called
A-Flex if in Auto-CPAP (or C-Flex+ if in CPAP mode).
When A-Flex (C-Flex+) is enabled, it enhances patient
comfort in three ways: 1) by smoothing the transition
between the end of inhalation and the beginning of
exhalation, 2) by providing significant pressure relief during
the beginning of exhalation, and 3) by reaching an end
exhalation pressure of no more than 2 cm H
high point of inspiration.
In the diagram, the dashed line represents CPAP
pressure in comparison to the bold line representing
A-Flex (C-Flex+). A-Flex (C-Flex+) levels of 1, 2, or 3
progressively reflect increased pressure relief during the beginning of exhalation.
With A-Flex (C-Flex+), the level of pressure relief at the beginning of exhalation is determined by the A-Flex
(C-Flex+) setting and the amount of patient flow in any one breath.
Note: A-Flex (C-Flex+) transitions from no A-Flex (C-Flex+) at 4.0 cm H
A-Flex (C-Flex+) is top limited at 20.0 cm H
WARNING: The effectiveness of the A-Flex, Bi-Flex, C-Flex, C-Flex+ or AVAPS therapy features or the autoSV
mode has not been established for pediatric patients at this time.
Bi-Flex Comfort Feature
If enabled, the device provides a comfort feature called Bi-Flex
in S, autoSV, and Auto-BiLevel modes. The Bi-Flex attribute
adjusts therapy by inserting a small amount of pressure relief
during the latter stages of inspiration and during active exhalation
(the beginning part of exhalation). Bi-Flex levels of 1, 2, or 3
progressively reflect increased pressure relief that will take place at
the end of inspiration and at the beginning of expiration.
WARNING: The effectiveness of the A-Flex, Bi-Flex, C-Flex,
C-Flex+ or AVAPS therapy features or the autoSV mode has not
been established for pediatric patients at this time.
Ramp
The device is equipped with an optional ramp feature.
The ramp feature is designed to offer lower pressures
when activated and then gradually increase to allow
the patient to fall asleep.
If ramp is activated with AVAPS enabled or in AVAPS-
AE mode, it will reduce the maximum pressure
support capability to IPAP Min or Pressure Support
Min and ramp to the IPAP Max or Pressure Support
Max. In AVAPS-AE mode, the EPAP will reduce to the
EPAP Min setting but is not ramped, and Auto-EPAP
adjusts the pressure according to the patient's needs.
During the ramp period, the IPAP or pressure support applied will be adjusted by the AVAPS algorithm but will be
constrained by the current maximum ramp pressure set point. The pressures (with exception of EPAP in AVAPS-AE
mode) will then ramp up to the original patient settings over the ramp time period.
12
Therapy
Pressure
A-Flex Levels
(1, 2 and 3)
O below the
2
O pressure.
2
Exhalation starts and
pressure level decreases
1
2
3
Exhalation
O to full A-Flex (C-Flex+) at 6 cm H
2
Time
O.
2
TIME