What is bilevel positive airway pressure (BPAP)?

Bilevel positive airway pressure (BPAP) is the second of two cardinal modes of noninvasive ventilation (continuous positive airway pressure, or CPAP, is the other).

As the name suggests, BPAP provides two different pressures during the respiratory cycle.

When a patient on BPAP breathes in, the ventilator will provide constant pressure during the inspiration. When the patient then breathes out, the ventilator will provide a different, lower pressure during expiration.

The ventilator settings for BPAP are as follows:

• Inspiratory positive airway pressure (IPAP), measured in cmH₂O
• Expiratory positive airway pressure (EPAP), measured in cmH₂O
• The fraction of inhaled oxygen (F_IO₂), set between 21% and 100%

The main clinical use for BPAP is in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

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