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YOUR INTENSIVE CARE HOTLINE - What’s the Difference Between BIPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)? Quick Tip for Families in Intensive Care!

/ Patrik Hutzel - Critical Care Nurse Consultant / No Comments

What’s the Difference Between BIPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)? Quick Tip for Families in Intensive Care!

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

So today’s question is about what’s the difference between BiPAP and CPAP?   It’s a question we get quite frequently and I think it is important for families in intensive care to know that.

Now, what makes me qualified to talk about these topics? I am a critical care nurse by background. I have been working in intensive care and critical care for over 20 years in three different countries where I also worked as a nurse unit manager for over five years and I have been consulting and advocating for families in intensive care all over the world for the last 10 years as part of my intensivecarehotline.com platform here. So let’s get right into answering today’s questions.

BiPAP and CPAP are both devices used in the treatment of sleep apnea as well as for example, respiratory failure type 1 and respiratory failure type 2 as well as sleep apnea, of course, but it is also sometimes used for neurological conditions. It’s used for post extubation when someone comes off the ventilator with a breathing tube. But I’ll come to that in more detail in a minute.

So CPAP (Continuous Positive Airway Pressure) provides a continuous stream of air at the fixed pressure to keep the airways open, preventing pauses in breathing. It’s commonly used for obstructive sleep apnea because this is an intensive care channel. CPAP is often used in the community for sleep apnea, but in intensive care, it’s often used to prevent either intubation or to prevent reintubation when patients are extubated.

BiPAP (Bilevel Positive Airway Pressure) on the other hand, offers two different pressure levels, a higher pressure for inhalation and a lower pressure for exhalation. This dual-level approach can be more comfortable for some individuals. It’s often prescribed for those who have trouble with CPAP or have certain medical conditions including high CO2 (carbon dioxide), high PCO2 (partial pressure of carbon dioxide), and have type 2 respiratory failure.

In summary, while CPAP provides a constant pressure, BiPAP provides different pressures for inhalation and exhalation, offering a more customizable breathing support.

Now, like I said, in intensive care, in particular, patients that are extubated, for example, they may struggle to breathe spontaneously and they might just need a little bit of CPAP or a little bit of BiPAP that’s also guided by arterial blood gases. For example, if you have a low PO2 (partial pressure of oxygen) or like low oxygen level in the blood, a little bit of CPAP might be sufficient. If you have a low PO2 and a high CO2, you probably need some BIPAP. This is after extubation, after the removal of the breathing tube, when people are struggling to breathe.

Now, when patients go into intensive care, they might also be started on BiPAP or CPAP with the mask to prevent intubation. Maybe the intensive care team, things are not quite ready. They don’t need intubation. Let’s just help them with breathing with the CPAP or BIPAP, check out your blood gases and see whether ventilation with BiPAP or CPAP is sufficient. And if it is, then that’s a good thing because then no intubation is needed. You want to avoid intubation whenever you can.

So I hope that helps.

And that explains the difference from BiPAP to CPAP. In essence CPAP one level of pressure, which is also known as PEEP (Positive and Expiratory Pressure). In BiPAP, it’s often PEEP and pressure support or IPAP (Inspiratory Positive Airway Pressure) and EPAP (Expiratory Positive Airway Pressure). Don’t want to get too medical here, but that gives you a really quick understanding of what the difference between CPAP and BiPAP is. I hope that helps.

If you need help when you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.

We also have a membership for families of critically ill patients in intensive care and you can get access to the membership when you go to intensivecarehotline.com and click on the membership link or you go to intensivecaresupport.org directly. In the membership, you have access to me and my team 24-hours a day in the membership area and via email and we answer all questions, intensive care related. I also offer one on one consulting and advocacy for families in intensive care over the phone, via Zoom, Skype, WhatsApp, whichever medium works best for you.

I talk to you and your families directly and I help you or I talk to doctors and nurses directly. And I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one in intensive care so that you can make informed decisions, and have peace of mind, control, power and influence.

I also represent you in family meetings with intensive care and I help you whether you should consider even going into a family meeting with intensive care. That is a consideration you need to make whether you should even go to a family meeting in intensive care. But I can help you with all of that with my one on one consulting and advocacy so that you make informed decisions, and have peace of mind, control, power and influence.

We also offer medical record reviews in real-time so that you can get a second opinion in real time when you have a loved one in intensive care. Once again, all with the goal of making informed decisions, and have peace of mind, control, power and influence. We also offer medical record reviews after intensive care. If you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

Now, if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, 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 intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

 

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