Not certain what BiPAP is or need help setup up BiPAP?BiPAP is a type of confident airway pressure (PAP) supplied to law obstructive sleep apnea. That can additionally be used in other problems where there is hypoventilation (under-breathing), such as morbid weight problems or chronic lung or muscle troubles such together chronic obstructive pulmonary condition (COPD). Setup up BiPAP can be confusing, and also if often not done well by homecare providers. This video explains what BiPAP is, why to usage it in sleep apnea, and also gives tips on setup up BiPAP and also determining appropriate pressure settings.
You are watching: How to set up a bipap machine
Video Timeline:00:00 – 02:22 What is BiPAP?02:22 – 03:37 Why usage BiPAP?03:37 – 05:58 setting up BiPAP
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I’m walking to try and define to girlfriend what the distinction is between EPAP, IPAP and CPAP. Basically to try and describe that, i will first talk about what happens in the upper airway and also what pressure we require in the top airway across the breathing cycle since if you can understand that, then it’s nice self-evident what the difference is in between these two settings.
In this lasignoralaura.component of the diagram, as we’re breath out, we’re efficiently blowing waiting from the lungs out with the upper airway and it actually inflates or blows open the top airway. For this reason the pressure we should keep one airway open once we’re breathing the end is much less than what we require when we’re breathing in.
The pressure that’s required while we’re sleep to save the airway open at the finish of breathing out is called EPAP. Therefore think the it together expiratory optimistic airway pressure yet that’s abbreviation to EPAP.
Now when we walk to breathe in and draw wait in through the upper airway, we in reality generate a sucking result in the top airway which then closes the airway. So naturally you would intend you require a higher pressure to store the airway open throughout the breathing in part of the cycle. It turns out it is true and also that’s called the inspiratory optimistic airway pressure so the pressure needed to store the airway open once we’re breath in.
There’s usually a minimum difference between the pressure to keep the airway open on breath out and the press to save the airway open up on breathing in of 3 centimetres of water pressure. The difference, the difference in between expiratory positive airways pressure and also inspiratory hopeful airways pressure is referred to as pressure support. For this reason in PAP terms, that would certainly be dubbed PS, pressure support, for this reason a minimum push support the three.
Now part people, an especially people who room overweight or got really collapsible airways, require a lot an ext pressure assistance than that since when they go to breathe in, the airway is very vulnerable lasignoralaura.come collapse. So the inspiratory pressure needs to be rather a lot greater than the expiratory pressure.
That difference can be as high together 15cmH2O. So we will usually have pressure support on an auto BIPAP device set at a minimum the 3 and also a best of 15.
So why actually bother? Why look at expiratory pressure, inspiratory pressure and make it an ext lasignoralaura.complicated? Well, actually there is part data suggesting it’s a bit an ext lasignoralaura.comfortable because that patients. Therefore if we’re setting the pressure, many of the time, to be able to cope through this where the airway is most fragile to collapse, as we walk to breathe out, we’re going to feeling the toughness of the pressure and find it a little bit harder to breathe out versus that resistance.
That’s among the things world describe with CPAP that deserve to be unlasignoralaura.comfortable for them, breath out against that pressure. It’s additionally one the the things that deserve to lead lasignoralaura.come air in the stomach, aerophagia. The trying to breath out against a greater pressure lasignoralaura.coming ago in. So that’s among the rationales for using a reduced pressure in expiration, EPAP, and also a greater pressure in inspiration.
Hopefully I’ve to be able to provide you an idea the the difference between EPAP and also IPAP but think of it about what’s keep going in the top airway and I think that enables you to gain past some of the confusion with the different terms and also think that it as we breathe out, us still need some pressure to keep the airway open since people with sleep apnea have actually a small airway. However as us breathe in, we require a higher pressure to save the airway open. The difference between those two is what we call the press support.
So in setup up a BiPAP maker for patients, what space the setups that we desire to look at on the machine? Well, the parameters we’re able to set are expiratory confident airway pressure, EPAP, the maximum inspiratory positive airway press so it is IPAP and the difference, the minimum distinction or minimum press support and the maximum difference, maximum press support.
The method I’ve manually identified the EPAP and this is what I carry out in the sleep laboratory and also I will involved what the auto machine is in reality going to carry out in the residence which is more relevant lasignoralaura.come what you’re doing. Manually in the laboratory what we will perform is gradually increase – us will have IPAP and EPAP precisely the same. For this reason we’re utilizing it choose CPAP. We will rise the pressures until we gain to enough pressure that even at the finish of breathing out, the airway is nice and also open, so that apnea is controlled.
Then we will collection that as our EPAP and also then we’re gradually increasing the pressure support, so the difference in between EPAP and IPAP. So till we acquire to a allude where when world are breath in, yes no snoring, yes no flow limitation, and then we understand what our ideal IPAP is and also we know the difference between our set EPAP and also our set IPAP and that provides us our press support.
Now as soon as you’re utilizing a BiPAP auto in the home, it actually does all that work-related for you. Yet at the very least if you understand how I do it manually, it gives you one idea of what it’s actually doing.
So a BiPAP auto will boost the EPAP until apnea is managed. Climate it will slowly increase the difference in between EPAP and IPAP to manage hypopnoea, circulation limitation, subtle airway narrowing and snoring.
The difference that friend need between these is going to differ in between the species of sleep you’re in, what stage of sleep, what human body position. For this reason it’s not always the same.
That’s where v the auto machines we collection these parameters. The minimum press support, 3, maximum press support, ns usually store that default at 15.
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So nothing be intimidated by a BiPAP auto. It’s in reality pretty straightforward to set the parameters and shot and think of that in this kind of framework of those the minimum expiratory optimistic airway pressure, what’s the best IPAP, the minimum press support and also the maximum push support.