Bilevel positive airway pressure

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The setup for BIPAP using a mechanical ventilator

Bilevel positive airway pressure (BiPAP) is a proprietary name of Respironics, Inc. for continuous positive airway pressure (CPAP) with pressure support breaths. It is used during noninvasive positive pressure ventilation. It delivers a preset inspiratory positive airway pressure (IPAP) during inspiration and expiratory positive airway pressure (EPAP). BiPAP can be described as a continuous positive airway pressure system with a time-cycled or flow-cycled change of the applied pressure level.[1] CPAP, BPAP and other non-invasive ventilation modes have been shown to be effective management tools for chronic obstructive pulmonary disease, acute and chronic respiratory failure.[2] Another term for bilevel positive airway pressure, and the term becoming increasingly adopted by the medical community, is non-invasive positive pressure ventilation (NIPPV) or non-invasive ventilation (NIV).[3]


Bilevel positive airway pressure is used when positive airway pressure is needed with the addition of pressure support. Common situations where positive airway pressure is indicated are those where taking a breath is difficult. These include pneumonia, chronic obstructive pulmonary disease, asthma and status asthmaticus.[4][5]

Settings and measurements[edit]


The term "Bipap" can be confusing due to the existence of two almost identical terms being applied to two different modes:


  1. ^ C. Hormann, M. Baum, C. Putensen, N. J. Mutz & H. Benzer (January 1994). "Biphasic positive airway pressure (BIPAP)--a new mode of ventilatory support". European Journal of Anaesthesiology 11 (1): 37–42. PMID 8143712. 
  2. ^ M. A. Levitt (November 2001). "A prospective, randomized trial of BiPAP in severe acute congestive heart failure". American Journal of Emergency Medicine 21 (4): 363–369. doi:10.1016/s0736-4679(01)00385-7. PMID 11728761. 
  3. ^ Guy W Soo Hoo, MD, MPH Clinical Professor of Medicine, University of California, Los Angeles, David Geffen School of Medicine; Director, Medical Intensive Care Unit, Pulmonary and Critical Care Section, West Los Angeles Healthcare Center, Veteran Affairs Greater Los Angeles Healthcare System; Oleh Wasyl Hnatiuk, MD, Francisco Talavera, PharmD, PhD (6 June 2011). "Noninvasive Ventilation". Archived from the original on 2010-06-07. Retrieved 7 June 2012. 
  4. ^ Williams AM, Abramo TJ, Shah MV, Miller RA, Burney-Jones C, Rooks S et al. (2011). "Safety and clinical findings of BiPAP utilization in children 20 kg or less for asthma exacerbations.". Intensive Care Med 37 (8): 1338–43. doi:10.1007/s00134-011-2238-9. PMID 21567114. 
  5. ^ Beers SL, Abramo TJ, Bracken A, Wiebe RA (2007). "Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics.". Am J Emerg Med 25 (1): 6–9. doi:10.1016/j.ajem.2006.07.001. PMID 17157675.