Under what condition is BiPAP contraindicated?

BiPAP, or bilevel positive airway pressure, is a noninvasive ventilation method commonly used to aid patients with respiratory disorders. It provides different levels of pressure for inhalation and exhalation. In the context of this question, dysphagia, or difficulty in swallowing, poses a significant concern when considering BiPAP therapy.

When a patient has dysphagia, there is a risk that they could aspirate, which is the inhalation of food, liquid, or saliva into the airway or lungs. This is particularly critical during the use of noninvasive ventilation, where air pressure is delivered through a mask that fits over the nose and/or mouth. If the patient cannot effectively protect their airway due to dysphagia, the pressure from the BiPAP can exacerbate the potential for aspiration, leading to serious complications such as pneumonia or respiratory distress.

In contrast, other conditions listed, such as severe asthma, obstructive sleep apnea, and chronic obstructive pulmonary disease (COPD), can often be managed with BiPAP. These conditions typically involve obstructive processes in the upper or lower airways, where noninvasive ventilation can relieve work of breathing and improve oxygenation without the same level of risk for aspiration as associated with