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BiPAP positive airway pressure (PAP) devices provide comfortable, convenient, and quiet therapy for people with obstructive sleep apnea (OSA) and complicating factors, such as restrictive or obstructive lung disease.

Obstructive Sleep Apnea (OSA) is a condition in which a patients breathing passage seals during sleep, causing the patient to stop breathing. Apnea is Latin for without breath. The body responds to this lack of oxygen by arousing, or waking from sleep. This cycle leads to the patient being unable to get the needed quantity of restful sleep and results in:

·Constant Fatigue

·Difficulty Focusing

·Irritability

BIPAP stands for Bi-level Positive Airway Pressure. BiPAP therapy provides a constant airflow which holds the airway open so that uninterrupted breathing is maintained during sleep. This eliminates Sleep Apneas and allows the patient to get a restful sleep.

BiPAP therapy is traditionally provided through a nasal mask that seals around the nose. However, more innovative, comfortable and better sealing options are beginning to emerge.

A BiPAP has two set pressures but some patients require a back up timed response in which the BiPAP will initiate a breath if a breath is not taken within the set timed parameters.

There is now Level I evidence that CPAP (Continuous Positive Airway Pressure) and BiPAP (Bi-level Positive Airway Pressure) are effective in preventing intubations and decreasing mortality in patients with Acute Respiratory Failure in properly selected patients. The use of these machines in sleep apnea or chronic respiratory failure will not be explored.

Different types of Bipap are available:

Bipap plus: The new BiPAP Plus starts with Respironics proven BiPAP technology at its core. The result is a smaller, easy-to-use BiPAP system with added treatment flexibility. The lighted controls are part of the BiPAP Plus unit, so they are always easy to find. And since the heater platform plugs into the device, there is only one plug to go into the wall. The Rise Time feature on the BiPAP Plus establishes the time that the device takes to change from EPAP to IPAP. This setting can be adjusted, giving you greater flexibility in matching patient’s therapy to their needs. Digital Auto-Trak Sensitivity triggers the BiPAP Plus to cycle between inspiratory and expiratory pressures based on the patients breathing rhythm.

BiPAP Pro 2 Machine: Respironics is proud to introduce the BiPAP Pro 2 with Bi-Flex Technology - a reliable, proven approach to treatment that makes breathing more natural. Bi-Flex softens the airflow in inhalation and exhalation. The amount of pressure relief at the end of inhalation and at the beginning of exhalation is determined by the Bi-Flex setting of the machine. This technology works together with Respironics digital Auto-Trak sensitivity technology. This technology triggers the BiPAP Pro 2 to cycle between inspiratory and expiratory pressures based on the patients breathing rhythm. Another great feature of the BiPAP Pro 2 is that this machine is Respironics first BiPAP with the option to add an integrated heated humidifier. This makes use of the machine and humidifier extremely easy since it is all built into one interface.

BiPAP Synchrony Machine: Synchrony can be adapted to meet a patients needs by offering flexibility in treatment options. The unit can be upgraded from Spontaneous Mode to a version with Spontaneous/Timed Mode. For greater flexibility, the unit has continuous positive airway pressure, Timed- and Pressure-Control Modes. Digital Auto-Trak Sensitivity has enhanced leak compensation to allow for better matching of the patients breathing pattern. Traveling is easy with the Synchrony, as it is DC capable and weighs only six pounds.

RPM Bi-Level Machine: The spontaneously triggered Bi-Level machine permits independent pressure profile control of inspiratory and expiratory breathing cycles and a high level of respiratory performance monitoring choices to increase patient comfort. This machine can be run two different modes; spontaneous BiPAP or conventional CPAP. With this machines ultra quiet operation, you can get a great machine without breaking the bank.

VPAP III BiPAP Machine: VPAP III bi-level positive airway pressure devices provide comfortable, convenient, and quiet therapy for people with obstructive sleep apnea (OSA) and complicating factors, such as restrictive or obstructive lung disease. Many OSA patients use bi-level devices because they need a lower pressure during exhalation. The lower pressure makes treatment more comfortable. Bi-level devices offer the most significant improvements in comfort when they achieve patient-machine synchrony. In other words, the bi-level device needs to stay in sync with you on each inhale and exhale.

As the use of BiPAP machines has increased, their cost has gone down. There are also more types of masks available and this has improved patient comfort and compliance. The use of BiPAP machines is often called non-invasive face mask ventilation. This is because the trachea is not incubated so there are fewer traumas to the airway and more importantly there is a lower incidence of nosocomial infections.

For acute respiratory failure however, compliance may be a problem. The respiratory technologist should be prepared to stay with the patient, while he/she gets used to the machine. It may be necessary to try several masks to provide effective ventilation that is comfortable for the patient. The patient must always be shown how to remove it in case of panic or vomiting. If the patient has a decreased level of consciousness, copious secretions, can not protect his airway or is unstable hemodynamically, then intubations is warranted.

Maintaining a good oxygen saturation can be accomplished by run the patient dry (with a diuretic) and set a high BiPAP (bidirectional positive airway pressure). Problem is that a high BiPAP leads to a poor venous return, which means the blood pressure suffers. Adding volume would help with the blood pressure, but would make the edema worse so it is generally avoided. Adding albumin does not help, the pulmonary arteries are too porous post-operation. So, a balancing act is required between blood pressure and oxygen saturation that is controlled

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