What is BiPAP Ventilation?

Bipap ventilation, also known as bi-level positive airway pressure, is a form of noninvasive positive airway pressure. It is considered noninvasive because a breathing tube is not inserted into the airway to deliver the pressure. A mask is worn, which is connected with tubing to a bipap ventilator.
Noninvasive positive pressure ventilation may be needed to treat sleep apnea or impending respiratory failure. Because pressure is delivered into the lungs, it can ease shortness of breath, improve oxygen levels in the body, and help reduce carbon dioxide levels. It may also prevent the need for a breathing tube and full support from a respirator.

Because bipap does not require a breathing tube, certain complications are avoided. Insertion of a breathing tube can lead to trauma to the teeth. Ventilator-associated pneumonia can develop with a breathing tube and life support. Sedation is also required with a breathing tube and can cause complications.

Two types of pressure are set during bipap ventilation — an inspiratory pressure and an expiratory pressure. This helps open up the lungs when the patient inhales and keeps them slightly open when the patient exhales. Oxygen can also be delivered through bipap ventilation.

There are various types of masks that can be used with this treatment. A mask that covers the entire face is one option. The other two types of masks include one that covers the nose and mouth and one that covers the nose only. Each mask has advantages and disadvantages and should be selected depending on the patient’s condition and tolerance. The mask needs to fit tightly to ensure the proper level of pressure is being delivered into the lungs.

Although bipap ventilation may improve breathing and stop respiratory failure, there are some instances when it should not be used. In cases where a patient is not able to breathe on his own, such as a coma or cardiac arrest, a bipap should not be used. Patients who do not have the ability to swallow or have severe vomiting should also not use bipap ventilation. In these cases, the patient will need to have a breathing tube inserted into the trachea.

There are some risks and complications that can develop when using bipap ventilation. Pressure sores can develop from using the mask. As the pressure is delivered into the lungs, some of the air may also enter the stomach. This can lead to gastric distension and nausea. Bipap ventilation can also cause drying of the mucus membranes in the nose and mouth.