BiPaP settings
A BIPAP machine is programmed to assist a patient’s spontaneous respirations by
delivering a flow of air at two different pressures:
positive pressure on inspiration (IPAP – Inspiratory Positive Airway Pressure)
and
positive pressure on expiration (EPAP – Expiratory Positive Airway Pressure).
In this way the BIPAP machine helps the patient to push air and oxygen into their lungs
and then helps to maintain airway patency, thereby allowing more oxygen to diffuse to
the pulmonary circulation.
BIPAP Modes
The mode controls how the BIPAP machine works to assist breathing.
The S or Spontaneous mode offers support to the breaths the patient takes on his/her
own.
The CPAP or Continuous Positive Airway Pressure mode supports spontaneous
respirations by providing one continuous positive pressure on inspiration and
expiration.
The S/T or Spontaneous/Timed mode offers a combination of machine delivered
breaths (set respiratory rate) and spontaneous (patient triggered) assisted breaths.
BIPAP Settings
IPAP – Inspiratory Positive Airway Pressure is the positive pressure generated during
inspiration allows the child to take a deeper breath than he or she would normally.
EPAP – Expiratory Positive Airway Pressure is the positive pressure generated during
expiration helps to splint open the upper airway, maintain the necessary resting volume
in the lungs at end of expiration and helps to avoid secretion build up and collapse. If
this resting volume is maintained, the lungs will also expand better.
RR – Respiratory Rate is the number of breaths the machine will deliver regardless of
patient effort.
Ti – Inspiratory Time is the length of time it takes for a “breath” to be delivered.
The Rise – is a function of how quickly the BIPAP machine will go from the EPAP pressure
to the IPAP pressure during inspiration.
BiPaP Set up Precautions:
1. Do not block air intake filter.
2. Should the power go out while the BIPAP is on, take the mask off.
3. Do not block exhalation port or built-in leaks on mask.
*All masks require an exhalation port attachment or a built-in leak in order for
CO2 to escape.
BCCH BIPAP Self Instructional Learning Package Acute Inpatient Units September 2012 7
BIPAP Equipment Care:
Equipment Cleaning and Disinfecting:
The BIPAP facemask and headgear needs to be always clean and dry.
RNs and RTs will clean the BIPAP mask (daily) and the headgear as needed.
The outside of the BIPAP machine can be wiped down with damp cloth when needed.
Please read the appendix for equipment cleaning instructions
Possible complications of BIPAP:
Skin Breakdown- check mask fit, the RT may try an alternate mask. Place
duoderm over area of breakdown.
Eye Irritation-check for leaks and mask pressure around eyes and refit as
appropriate.
Sinus Congestion-check mask tightness, RT may consider adding
humidification to BIPAP or increasing the temperature of the humidity.
Consult physician to discuss adequate fluid intake and/or consider a
nasal spray.
Oro/nasal Drying- see information for sinus congestion.
Patient Discomfort with Ventilation- Contact RT and physician to discuss
ventilator settings.
Gastric Distension- If noted, inform physician and discuss placement of NG
or OG tube for air venting.
Aspiration- Contact physician to assess feeding parameters.
Why might I need to use BiPap?
BiPap may help you if you have a medical problem that impairs your breathing. For example, you might need BiPap if you have any of the following:
COPD (chronic obstructive pulmonary disorder)
Obstructive sleep apnea
Obesity hypoventilation syndrome
Pneumonia
Asthma flare-up
Poor breathing after an operation
Neurological disease that disturbs breathing
Difficulty breathing in congestive heart failure
