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During a bilevel titration, what parameter is increased to eliminate apneas?

IPAP

Increasing the IPAP (Inspiratory Positive Airway Pressure) is effective in eliminating apneas during a bilevel titration. The primary role of IPAP is to provide additional pressure during inhalation, enhancing airflow into the lungs and increasing tidal volume. This increase in pressure helps to keep the upper airway open and prevent collapse, which is a common cause of apneas, particularly in patients with obstructive sleep apnea.

When IPAP is increased, it improves the oxygenation and ventilation in the patient, reducing the occurrence of apneas and hypopneas. It directly addresses the necessity for greater inspiratory support, aiding in the normalization of breathing patterns during sleep.

While EPAP (Expiratory Positive Airway Pressure) is important for maintaining airway patency during exhalation, the focus in eliminating apneas primarily lies with the inspiratory pressure provided by IPAP. Pressure support adjusts the difference between IPAP and EPAP but does not directly target the elimination of apneas. The BiPAP rate refers to the timing and frequency of the pressure changes, but increasing IPAP specifically addresses the fundamental issues leading to apneas. Thus, boosting IPAP is the most direct and effective method to resolve apneic events during bilevel titration

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EPAP

Pressure support

BiPAP rate

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