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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is about a question that we get quite frequently, and the question is, “Is BIPAP considered life support? Even though I think I know the answer, as part of my research, I typed that into Google and had a look what the answer is from Google. And there’s no straightforward answer from any article, whether it is considered life support, or it’s not considered life support. Now, let me break this down for you. And from my experience, the answer is that it really depends.

So, there are people at home that have BIPAP for sleep apnea and they are perfectly healthy during daytime. They go about their business, they go about their lives, but they have a BIPAP machine overnight because they have obstructive and sometimes central sleep apnea. And if then wouldn’t be using BiPAP, their CO2 or carbon dioxide would rise, and they would become drowsy and sleepy.

Is that considered life support? One might argue that it is life support because what if CO2 keeps rising? People get confused and drowsy, and they have a fall and they hit their head and they end up in ICU. So, one could argue that this might be considered life support.

Looking at it from an intensive care perspective, I believe that BIPAP is life support. So, when patients go into ICU, for example, through the emergency department or emergency rooms and they need mechanical ventilation, but they’re not quite ready or they don’t need a breathing tube yet and an induced coma, but they need mechanical ventilation, they may be hooked to BIPAP. Maybe they have pneumonia, they have some type of respiratory failure, type one or type two, and if they weren’t commenced on BIPAP and get some positive air into the lungs again, they might die. They might end up in with a respiratory arrest that could lead to a cardiac arrest. List of complications is very long. So, from that perspective, in my mind it is life support.

If then BIPAP, God forbid, is not sufficient, BIPAP with a mask and a patient needs intubation and an induced coma goes on mechanical ventilation with a breathing tube, again, that is life support as well. But I guess BIPAP really initially even with a face mask, also known as non-invasive ventilation, is a form of life support.

Another form of life support with BIPAP is, for example, ventilation via a tracheostomy or with a breathing tube. There are some patients that need BIPAP either with a breathing tube or a tracheostomy. Again, that in my mind is life support. If they weren’t having the BIPAP, again, they could be medically impaired and their condition could deteriorate, making things go from bad to worse. Again, especially if CO2 is rising and if they’re hypoventilated, i.e., their oxygen levels are dropping as well, so again, from that perspective, I believe it is life support.

Last but not least, BIPAP, generally speaking, is initiated spontaneously. However, there are BIPAP forms as well where I’ve seen either invasively or noninvasively where people are put on a rate like they get 15 breaths per minute delivered by the machine, and they can trigger breaths on top of that. But BIPAP is not necessarily a spontaneous ventilation form. It can be a mandatory ventilation form as well. Generally speaking, the aim or the goal of BIPAP is to remove CO2, keep CO2 levels down. That’s why the BIPAP gives you two levels of PEEP (positive end expiratory pressure) to keep CO2 levels down.

So, that is my quick tip for today.

Now also, if you have a loved one in intensive care you should contact us at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

Also, if you have a loved one in intensive care on BIPAP and they can’t leave intensive care, they’re stuck there because of BIPAP dependency, you should check out intensivecareathome.com. Go to intensivecareathome.com. There, we provide home care for long-term intensive care patients, predominantly with invasive and non-invasive ventilation. Invasive ventilation via tracheostomy and non-invasive ventilation such as CPAP or BIPAP via the tracheostomy, generally speaking. But any form of ventilation really. If your loved one or yourself is stuck in ICU and you’re watching this video, contact us at intensivecareathome.com.

We are predominantly serving all areas in Australia at the moment but even if you are overseas in the U.K., U.S., you should contact us as well. We have potentially some contacts and also some tips and tricks for you how we can hopefully minimize your stay in ICU.

Now, also have a look at our membership at intensivecaresupport.org. There, we have a membership for families in intensive care and you have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all questions intensive care and Intensive Care at Home related.

Also, if you need a medical record review, please contact us as well. We review medical records for families or for patients in ICU and we review them in real time, or we also review them after intensive care if you suspect medical negligence. But it is so much better if we can review them in real time and give you a second opinion and help you to ask all the right questions or we can even ask the questions on your behalf.

Now, like the video, subscribe to my YouTube channel for regular updates for families in intensive care and Intensive Care at Home, click the like button, share the video with your friends and families, and comment below what you want to see next, or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from Intensive Care Hotline and intensivecareathome.com, and I’ll talk to you in a few days. Take care.