Controlling inspiratory time limits can be useful when treating those with respiratory disorders. During pressure support ventilation, early or late cycling can occur. To help prevent this, TiControl allows the clinician to set minimum and maximum time limits for inspiration.

 

TiControl can be used to manage high leak or customise therapy according to the patient’s disease state. For example, in patients with highly restrictive lung mechanics, TiMin may be used to extend the inspiratory phase. The result is better patient and therapy outcomes.

 

How it works

TiControl allows you to set minimum and maximum inspiratory time limits on either side of the patient’s ideal spontaneous inspiration time. This provides a window of opportunity for the patient to spontaneously cycle to the set expiratory pressure (EPAP).

 

The TiControl TiMax feature can eliminate late cycling to provide sufficient expiratory time. This may be most beneficial during large leak or in treating patients with obstructive lung mechanics, for example, chronic obstructive pulmonary disease (COPD) or overlap syndrome (i.e. COPD with OSA).

 

The TiControl TiMin feature prevents premature cycling to allow sufficient inspiratory time. An extended inspiratory phase may be most beneficial for patients with highly restrictive lung mechanics, for example, Amyotrophic Lateral Sclerosis (ALS) and other neuromuscular disorders, chest wall deformity and post-polio.

 

Why TiControl is valuable

Altered lung mechanics in patients with COPD and obstructive lung disorder can cause air trapping, intrinsic PEEP and late cycling. The combined effect prolongs time spent in IPAP and leaves insufficient time for the lungs to empty during EPAP. The TiMax setting allows the physician to set a reasonable maximum inspiratory time to ensure adequate time for the patient to exhale through diseased airways to achieve more complete lung emptying.

 

In patients with restrictive respiratory disorders (such as ALS, chest wall deformity and post-polio) the challenge is usually under-ventilation. This results from weak inspiratory effort and restrictive lung mechanics causing shortened inspiratory time. The patient may wake up many times during the night feeling suffocated. The TiMin setting enables the physician to set a reasonable minimum inspiratory time, ensuring that an adequate volume is delivered to the lungs. This can alleviate the sensation of dyspnea and breathlessness, reducing the associated panic-attacks.

 

In patients with a normal respiratory system and OSA and/or OHS (obesity hypoventilation syndrome) the main challenge is maintaining reliable breath synchronisation even during large and variable mask and mouth leak. During such leak, the inspiratory time may become prolonged resulting in poor breath synchrony. ResMed's Vsync leak management algorithm is the first line of defence. TiControl forms the second line of defence, allowing the physician to customise the maximum inspiratory time to avoid prolonged inspiration and maximise synchrony.

 

What this means for the patient and the physician

The physician can customise therapy according to their patient's condition. This means more comfortable therapy for the patient, with fewer arousals and less complaints about feeling as though they are breathing against the device.