Frequently Asked Questions

1 6 VENTILATOR-ASSISTED LIVING 2008 BVol. 22, No. Asked QuestionsVented or non-vented masks?One frequent question Asked of IVUN and on the vent users listservs is aboutwhich type of mask to use with which ventilator in order to avoid triggeringalarms. Vented masks are needed with CPAP units and bilevel devices; non-vented masks are needed with volume/pressure ventilators. A recent questionbelow was answered by three respiratory ve been using a ventilator since birth due to CCHS (chronic central hypo-ventilation syndrome). Recently I switched from using trach positive pressure tousing noninvasive ventilation via a vented nasal pillows mask (Swift II, ResMed).In order for this mask to work with the LTV 950, I have to seal the exhalationports on the mask with tape. I use the volume mode on my LTV, and if the nasalmask is not sealed, an alarm is triggered. How can I use the nasal maskwithoutsealing the ports?

2 Would pressure support mode be the way to do it? vents on a mask need to be kept plugged when used with a volume orpressure support ventilator. Most noninvasive interfaces were designed for usewith bilevel or CPAP units which do not have an exhalation valve and need theexhalation ports on the mask to avoid possible carbon dioxide (CO2) buildup. Louie Boitano, RRT, Northwest Assisted-Breathing Center, University of Washington Medical Center,Seattle, Washington, ventilators such as theLTV 950 are designed to functionwith a closed circuit. A valve on theventilator opens during inhalationand closes during exhalation. There-fore, if there is a leak in the system,such as with a vented mask, the valvewill not close, exhalation will not end,and an alarm will trigger. It makes no difference whether the vent is involume or pressure support are a limited number of masksthat are manufactured without vents ,such as a version of ResMed s UltraMirage nasal mask.

3 The exhalation ports on some masks,such as ResMed s Swift LT (see page8) and Fisher & Paykel s Opus II,easily can be obstructed with , it is difficult to obstructexhalation ports on some masks. Onecreative RT has used a silicone sealantcalled Marine Tex to plug the exhala-tion ports on certain designed for CPAP (ContinuousPositive Airway Pressure) and bilevelunits that function with a continuousflow of air need vents , because theunits do not have exhalation valvesbuilt in as the valves are on a volumeventilator. There are many ventedmasks available. Diana Guth, RRT, Home Respiratory Care, Los Angeles, California, masks cannot be usedwith volume-cycled ventilators, suchas the LTV 950. Vented masks arespecifically designed to be used withbilevel units. Only non-vented masksor vented masks with the vent sealedwill work because the ventilator willdetect the air leak and will use of any type of nasal maskmay also present a problem due tooral air leak that will also cause theventilator to alarm.

4 Ventilator alarm-ing is often a problem when usingvolume-cycled ventilators for non-Ultra Mirage II by ResMed:Non-ventedOpus II by Fisher & LIVING BFall 2008 BVol. 22, No. 3 7invasive ventilation applications. It isnot impossible to limit the problembut may take some time adjusting thesystem to get past the problem. Lou Saporito, RRT, BS, Millennium RespiratoryServices, Whippany, New would like to buy a pneumobelt. I understand that Respironics Inc. manufactures and sells them, butwhen I call customer service, I m toldthey do not make Philips Respironics, the company does indeed make the pneumobelt, aka the exsufflation do not sell directly to the generalpublic. Your physician must give youa prescription for the exsufflation belt,which you can then give to a durablemedical equipment provider, such asyour home health care agency. Here are the part numbers and sizes:Exsufflation Belt, with Bladder and Corset:11010 Large 11020 Medium11030 SmallIVUN s Ventilatory Equipment have several pieces of older equipment ( , Thompson Bantam respirator, Model B, Monaghan 515 IPPB, last used November 2005) to IVUN accept this donation?

5 Has established an online Ventilatory Equipment Exchange. Peoplewho want to donate older, no longer used ventilatory equipment and aids canlist them on the IVUN website ( ). Peoplewho need older equipment can view what is available and make arrangementsfor the equipment exchange and/or submit their equipment needs. One thingIVUN has learned over the years is to advise people to be sure they own theequipment before they donate it. Send an email to Include your name, city, state, email and your ventilatory equipment offer or need. IVUN publishes only your first name, city, state/province, country (if outside USA), and email address,unless you specify