BIPAP ventilation

Specialties MICU

Published

Hello

I am currently working in ICU. Recently we have bought a ventilator capable of BIPAP ventilation which has now become a favourite mode for our unit director. However most of the staff are unfamiliar with this mode. Can anyone provide any info about setting up, suitability, weaning patients and documentation with regard to this mode. I would be most grateful because I have a teaching session to plan on this. Thank you

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I believe that the BIPAP you are referring to is bilevel CPAP (also known as Bilevel) , which is similar to APRV (airway pressure release ventilation). It's a confusing name because there is also BiPAP (from the Respironic BiPAP machine) which is non-invasive positive pressure delivered by nasal or full facemask.

You best bet is to find your friendly respiratory therapist who can provide you the best answer. I was a friendly RT four yrs ago but the vents keep getting smarter and they keep coming up with new modes of ventilation.

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Best used on COPD exacerbation and CHFers. BiPAP is like putting pressure support ventilation through a mask. There are two levels of pressure. 1) EPAP or PEEP which is the lower level usually set from 8-12 cmH2O and helps to splint the airways open 2)IPAP or PSV which assists the pt. to breath on inspiration. this is usually set 2 cmH2O or higher then the EPAP. titrated to the Work of breathing. Weaning is usually done by taking off the mask when the pt. can't stand it anymore. some pts. seem to become afraid to come off BiPAP at times and have to be reassured that their breathing is OK.

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As far as I understand it, the modes of ventilation on any brand ventilator can be labeled anything the manufacturer wants. So the term 'BiPAP' is actually a brand name that belongs to Respironics and whatever other company owns them. The techinical name for 'BiPAP' is NIPPV (Non-invasive positive pressure ventilation) and usually refers to .....you guessed it....positive pressure ventilation with a mask. The most commmon NIPPV machines can deliver a set FiO2, offer 2 levels of pressure to ventilate the Pt by. NIPPV is contraindicated in the apneic Pt. A RR is set, however its only a back up rate meaning it will try to deliver a set number of breaths if the Pt becomes apneic. Because it is non invassive, Pt readings (such as Vt) can only be estimated. Many invasive ICU ventilators have modes that provide similar support as NIPPV, but through an ETT. This is most often the 'CPAP' mode, not to confused with Continous Positive Airway Pressure (A different mode of NIPPV). Respironics (or whoever owns them) may indeed make an invasive ventilator, and it may have a mode called "BiPAP', I haven't seen it though.

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Holy jeez, was that question from 1998?!?!

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Holy jeez, was that question from 1998?!?!

Yeah, I noticed that after I posted a reply . . . so I'm sure that the OP wasn't referring to BiLevel!!

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