Bilevel Positive Airway Pressure (BiPAP)

Respiratory Nursing

Nursing Care of Patient with Ventilatory Support

Bilevel Positive Airway Pressure (BiPAP)

Physiology

Noninvasive Ventilation

The BIPAP type of ventilators deliver high-flow positive pressure cycling between a high positive pressure and a lower positive pressure.

In spontaneous mode, the flow rate of the patient triggers the ventilator to deliver a volume of gases at the higher pressure level (inspiratory PAP = IPAP) during a preset time or until the patient's flow falls below a threshold level. Then the expiratory phase evolves to the lower pressure (expiratory PAP =EPAP). This mode of ventilation is similar to pressure-support ventilation.

With BiPAP inspiratory and expiratory pressures can be set independently; BiPAP may be triggered to augment the patient's spontaneous inspiration, or it may work independently.

Advantages of NIPPV
	Preservation of away defence
	- Decrease nosocomial pneumonia - Less ICU care required - Decrease cost of care
	Enhance comfort & communication
	Less sedation

Limitations of NIPPV
	Need co-operation
	Facial trauma
	Difficult to assess airway

Nursing Management in Patient on NIPPV

1.	Pyschological care
	- clear explanation are essential to successful application
2.	Facial skin protection
3.	Appropriate masks
4.	Ensure the functioning of the system setting of machine
5.	Maintain adequate humidification
6.	Monitor the progress, improvement & compliance of the patient
7.	Assist in ADL