Bi-Pap versus Ventilators

"Noninvasive ventilation refers to positive-pressure mechanical ventilation using a facial or nasal mask, which may avoid or delay the need for endotracheal intubation. Several modalities can be used noninvasively continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), pressure support ventilation (PSV), and pressure control ventilation (PCV). . . . With BiPAP inspiratory and expiratory pressures can be set independently; BiPAP may be triggered to augment the patient's spontaneous inspiration, or it may work independently."

This is from Pulmonary/Respiratory Therapy Secrets. The advantages of noninvasive ventilation are that endotracheal intubation and its complications can be avoided; the patient is more comfortable; and it's possible to speak and swallow if nasal ventilation is used. With a face mask, however, the patient still will not be able to talk, eat, or swallow.

"Recent studies have shown that noninvasive ventilation is effective in preventing intubation in patients with exacerbations of COPD and useful for patients with congestive heart failure who have pulmonary edema. . . . Noninvasive ventilation also has been used successfully for patients who refuse intubation."

Sometimes the information is out-of-date or there are other opinions on the subject but it at least arms you with questions for the doctor.

The following is some excerpts from our members regarding their experiences being on a ventilator as opposed to the less invasive Bi-Pap.

My friends at EFFORTS: I am almost afraid to ask this question but here goes anyway. Have any of you had to get that ventilator? Could someone please explain what this thing is and how it works?

Besides being intubated twice I was also put on the BiPap "non-invasive" type of ventilation, twice. The BiPap is a better way to go IF it is possible that it will do the job. It depends on the severity and the circumstances of the situation.  

The two times I was vented by the endotrachael method there was no choice about it, I was arresting and there was no time to try it to see if a BiPap would work out . The two times I was put on a BiPap I was not in as serious condition as before but serious enough to need ventilation. On those occasions the Doctor chose to try the BiPap first and would have switched me over to the intubation if it became necessary. Fortunately it worked out, but it I was under the threat of having to switch over for a few days. Some people can't tolerate the BiPap. There is quite a forceful burst of air that goes into your lungs, (at least that was the way it was adjusted for me) and you have to learn to just relax and let it breathe for you.

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