There are many abbreviated terms when referring to breathing devices, BIPAP and CPAP are 2 terms that fall under the category of NPPV. NPPV stands for non-invasive positive pressure ventilation. This is a means of supporting the lungs when someone is unable to adequately breathe on his or her own. The term non-invasive means that the ventilation device is not placed within the body, but in this case on the outside of the face.
CPAP stands for continuous airway pressure; this abbreviation is becoming quite popular in society today, since so many people are discovering that they have obstructive sleep apnea (or OSA). There are differences between the two major forms of NPPV, CPAP and BIPAP, but the one thing that both BIPAP and CPAP have in common is the “PAP”, positive airway pressure. PAP can be explained as an amount of air pressure that blows forward (in a positive direction) creating enough force through a person’s nose or mouth (in the case of NPPV) to inflate the lungs.
A Physician will prescribe CPAP when a diagnosis of obstructive sleep apnea has been made. Although the symptoms of OSA (snoring, gasping, cessation of breathing while asleep) are usually clearly described by the patients who have them, a sleep study must be done to confirm it. During a sleep study the minimum pressure that is needed to open the persons airway will be determined through a series of tests. The typical amount of pressure will range from 6cmH2O to 12cmH2O, the higher the number the stronger the force of pressure required.
Although the name BIPAP doesn’t sound all that different from CPAP, it does represent a different type of ventilation. BIPAP ventilation supplies two levels of air pressure, one level is used as the person inhales and the second pressure is a pressure that keeps a portion of the lungs open continuously during exhalation. The prescription for BIPAP will read: IPAP/ EPAP. BIPAP is often used in the emergency room for someone that is in respiratory distress due to an exacerbation of COPD, or CHF (congestive heart failure). The two levels of pressure make breathing much easier since the EPAP supplies the lungs with a significant amount of residual volume. In an acute situation, both pressure levels may be set quite high, for instance 20cmH2O/8cmH2O.
BIPAP machines have functions that CPAP machines do not. They have a back-up respiratory rate, an inspiratory time, and some have the ability to completely ventilate a person with either pressure or volume ventilation.
Both CPAP and BIPAP
The latest versions of NPPV are being made to come close to a ventilator. CPAP machines that are used for home use have the prescribed pressure set into the machine before it is given to the patient. These machines are capable of differentiating between the types of masks used for instance, a full-face mask as opposed to a nasal mask or nasal pillows. Both CPAP and BIPAP machines have alarms on them. The main alarm on a home-care machine will tell a person if the mask is creating a leak in the airway pressure caused by being too loose. Machines that are made for hospitals contain many alarms such as: low pressure, high pressure, low or high respiratory rate, loss of power and battery on or off. These machines are usually hooked up to a 50psi oxygen source in order for them to run and supply oxygen. CPAP machines at home are usually supplied with oxygen through a concentrator or an oxygen E cylinder. The tubing on home-care machines are made to be periodically cleaned and reused whereas all equipment that is used in a hospital (these days) is meant to be for single patient use only.
Non-invasive ventilator devices are becoming a normal means of ventilation in acute care facilities as well as for homecare patients. The manufactures of these machines are continually adding new technology to make them safer and more effective for various types of breathing disorders. These machines can prolong life as well as safe a life in an acute situation.