BiPAPBPAP

BiPAP, or bilevel positive airway pressure, is a form of noninvasive ventilation that delivers two pressures through a mask: IPAP during inspiration and EPAP during expiration. IPAP augments tidal volume and ventilation; EPAP keeps the airways open to improve oxygenation and reduce work of breathing. Compared with CPAP, which provides a single continuous pressure, BiPAP supports ventilatory effort and can reduce CO2 retention in appropriate patients.

BiPAP is used in hospital and home settings for conditions causing hypoventilation, acute respiratory failure, and select sleep-disordered breathing. Common indications include acute COPD exacerbation, congestive heart failure with pulmonary edema, obesity hypoventilation syndrome, neuromuscular diseases, and certain cases of obstructive sleep apnea with hypoventilation. It may be employed as post-extubation support or chronic ventilatory assistance when spontaneous breathing is insufficient.

Modern devices offer modes such as spontaneous (S) with timed backup breaths (S/T) and occasionally auto-adjusting BiPAP. Typical starting ranges are EPAP around 4–6 cm H2O and IPAP around 8–12 cm H2O, adjusted to achieve adequate ventilation and patient comfort; humidification is often used.

Contraindications include inability to protect the airway or clear secretions, facial trauma, coma, inability to cooperate, or severe hemodynamic instability. Risks and side effects include mask discomfort, skin breakdown, nasal dryness, aerophagia, and rare aspiration.

BiPAP BPAP is commonly used to describe bilevel positive airway pressure delivered noninvasively; the terms are often used interchangeably.