BiPAPtherapie

BiPAPTherapie refers to the use of bilevel positive airway pressure delivered through a noninvasive ventilation (NIV) system. The therapy provides two distinct pressure levels: IPAP during inhalation and EPAP during exhalation, delivered through a mask or, less commonly, a mouthpiece. Compared with continuous positive airway pressure (CPAP), BiPAP allows a higher pressure during inspiration and a lower pressure during expiration, which can reduce the work of breathing and improve ventilation without an endotracheal tube.

BiPAP is used in several clinical settings. It is commonly employed for noninvasive ventilatory support in acute or chronic respiratory failure, such as COPD exacerbations, as well as in neuromuscular or chest wall disorders that impair ventilation. It can also be used for postoperative support or weaning in selected patients, and for certain forms of obstructive sleep apnea or complex sleep-disordered breathing when variable ventilatory needs exist.

Devices and administration involve a noninvasive ventilator connected to a facial or nasal mask, sometimes with humidification. Treatment parameters are adjusted by clinicians and include IPAP, EPAP, and, in some cases, a backup breathing rate. Additional options such as ramp time or pressure support adjustments help improve comfort and tolerance. Proper fit, skin care, and monitoring for leaks are important.

Contraindications include inability to protect the airway, severe facial trauma, uncooperative or unconscious patients, excessive secretions, or conditions where NIV is unsafe. Risks include mask discomfort, skin breakdown, nasal dryness, aerophagia, gastric distention, and potential aspiration if airway protection is compromised.

Evidence supports BiPAP in reducing intubation rates and mortality in select COPD exacerbations, improving gas exchange, and aiding weaning in appropriate patients. In chronic use, home BiPAP may be prescribed for chronic hypoventilation and certain neuromuscular conditions, with ongoing medical supervision.