IPAP

IPAP, or inspiratory positive airway pressure, is a setting used on bilevel positive airway pressure (BiPAP) devices and other non-invasive ventilation systems. It represents the positive airway pressure applied during the inspiratory phase of breathing. EPAP is the corresponding expiratory pressure, and the difference between IPAP and EPAP provides inspiratory pressure support (PS).

IPAP is selected to augment tidal volume and improve ventilation in patients who require non-invasive support, such as those with COPD, neuromuscular disorders, or certain forms of respiratory failure. Adjusting IPAP changes the amount of support provided during inspiration; higher IPAP increases ventilation but can reduce comfort and increase risk of aerophagia and barotrauma. EPAP maintains airway patency and prevents collapse; both are adjusted to balance ventilation and patient tolerance.

Typical clinical ranges are device- and patient-specific; IPAP commonly falls in the 8–20 cm H2O range, EPAP in the 4–8 cm H2O range, but targets vary widely. Clinicians tailor settings based on clinical response, comfort, tidal volume, and gas exchange goals. Ongoing monitoring uses device data, patient symptoms, and, when indicated, arterial blood gases or capnography.

Potential side effects include mask leakage, dryness, nasal congestion, aerophagia, and, rarely, barotrauma. Proper mask fitting, gradual titration, and symptom-based adjustments help minimize issues.