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What is BiPAP Ventilation?

M. DePietro
M. DePietro

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.

A man using a BiPAP breathing mask.
A man using a BiPAP breathing mask.

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.

Untreated sleep apnea can make it difficult to stay awake during the day.
Untreated sleep apnea can make it difficult to stay awake during the day.

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.

Use of a biPAP machine may relieve nighttime headaches caused by sleep apnea.
Use of a biPAP machine may relieve nighttime headaches caused by sleep apnea.

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.

Ventilators require a breathing tube to be inserted into the throat and down the trachea.
Ventilators require a breathing tube to be inserted into the throat and down 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.

Discussion Comments

anon1002944

I used drugs to get myself to not fight the cpap/bipap. It took a while to get used to it. took a few months. Now, l look forward to using it.

mdepietro

Bipap is often used before intubation. Some people do have trouble tolerating it. Maybe a different type of mask. Sometimes medication for anxiety helps.

anon137747

Is bipap a last resort before being incubated? My father keeps pulling his mask off during the night. Is there something we can do to help him keep this on. He is claustrophobic so this is a big problem. Thank you.

anon132402

I have a patient with severe neuromuscular disease, has very poor cough reflex. She has tracheostomy tube. Can you tell me how to give bipap ventilation in this patient with bipap machines. Thanks.

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    • A man using a BiPAP breathing mask.
      A man using a BiPAP breathing mask.
    • Untreated sleep apnea can make it difficult to stay awake during the day.
      By: Halfpoint
      Untreated sleep apnea can make it difficult to stay awake during the day.
    • Use of a biPAP machine may relieve nighttime headaches caused by sleep apnea.
      By: inesbazdar
      Use of a biPAP machine may relieve nighttime headaches caused by sleep apnea.
    • Ventilators require a breathing tube to be inserted into the throat and down the trachea.
      By: snapgalleria
      Ventilators require a breathing tube to be inserted into the throat and down the trachea.
    • Patients with obstructive sleep apnea typically experience intermittent cessations of breathing while sleeping.
      By: Konstantin Yuganov
      Patients with obstructive sleep apnea typically experience intermittent cessations of breathing while sleeping.
    • Vasoconstrictor nasal sprays may be used to treat nasal congestion caused by a BiPAP device.
      By: florinoprea
      Vasoconstrictor nasal sprays may be used to treat nasal congestion caused by a BiPAP device.
    • Prolonged use of BiPAP ventilation machine may cause drying of the mucus membranes in the nose.
      By: petrrunjela
      Prolonged use of BiPAP ventilation machine may cause drying of the mucus membranes in the nose.
    • Some people may experience a dry throat after using a BiPAP ventilator.
      By: zinkevych
      Some people may experience a dry throat after using a BiPAP ventilator.