Bi-level

Bi-level Positive Airway Pressure
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Synonyms	BiPAP
Pronounce	N/A
Specialty	Pulmonology
Symptoms	Difficulty breathing, sleep apnea
Complications
Onset
Duration
Types	N/A
Causes	Obstructive sleep apnea, respiratory failure
Risks
Diagnosis
Differential diagnosis	CPAP, mechanical ventilation
Prevention	N/A
Treatment	Bi-level positive airway pressure therapy
Medication
Prognosis
Frequency
Deaths	N/A

Bi-level Positive Airway Pressure (BiPAP) is a non-invasive ventilation therapy used primarily to treat patients with obstructive sleep apnea and other conditions that cause difficulty in breathing. Unlike Continuous Positive Airway Pressure (CPAP), which provides a single continuous pressure, BiPAP delivers two levels of pressure: a higher pressure during inhalation and a lower pressure during exhalation.

Mechanism of Action

BiPAP machines are designed to assist patients who have difficulty breathing on their own. The device consists of a mask that fits over the nose or mouth, a tube that connects the mask to the machine, and a motor that blows air into the tube. The machine is set to deliver two levels of pressure:

• Inspiratory Positive Airway Pressure (IPAP): This is the higher pressure that helps the patient inhale by keeping the airways open.
• Expiratory Positive Airway Pressure (EPAP): This is the lower pressure that allows the patient to exhale more easily.

The difference in pressure helps to improve ventilation and oxygenation, making it easier for patients to breathe.

Indications

BiPAP is commonly used in the following conditions:

• Obstructive Sleep Apnea: BiPAP is often prescribed for patients who cannot tolerate CPAP or who require higher pressure settings.
• Chronic Obstructive Pulmonary Disease (COPD): BiPAP can help reduce the work of breathing and improve gas exchange.
• Respiratory Failure: In cases of acute or chronic respiratory failure, BiPAP can provide necessary ventilatory support.
• Congestive Heart Failure: BiPAP may be used to reduce the workload on the heart and improve breathing.

Advantages

BiPAP offers several advantages over other forms of non-invasive ventilation:

• Improved comfort due to lower pressure during exhalation.
• Better compliance in patients who find CPAP uncomfortable.
• Ability to deliver higher pressures when needed.

Potential Complications

While BiPAP is generally safe, there are potential complications, including:

• Nasal dryness or congestion
• Skin irritation from the mask
• Aerophagia (swallowing air)
• Sinus discomfort

Comparison with CPAP

BiPAP and CPAP are both used to treat sleep apnea, but they differ in their pressure delivery. CPAP provides a constant pressure, while BiPAP offers variable pressures. BiPAP is often preferred for patients who need higher pressure support or have difficulty exhaling against continuous pressure.

Also see

• Continuous Positive Airway Pressure
• Obstructive Sleep Apnea
• Chronic Obstructive Pulmonary Disease
• Respiratory Failure