Abstract Koronis Biomedical Technologies proposes to develop and fully evaluate a novel, on-demand handheld bi-level positive airway pressure (BiPAP) ventilator to treat Chronic Obstructive Pulmonary Disease (COPD) patients suffering from exertional dyspnea (“breathlessness”). It is well known that dyspnea trends severe COPD patients as they age towards inactivity, resulting in peripheral muscle deconditioning that further increases the risk of experiencing dyspnea, establishing a vicious cycle of recurrent fear of dyspnea, further inactivity and potential social isolation. The proposed Bi-level Rapid Emergency Airway THErapy (BREATHE) system will be optimized to provide proven BiPAP therapy to rapidly relieve acute dyspnea in a miniaturized, portable handheld form factor. This system will allow for therapy on the go, untethering the patient and increasing their confidence to engage in activities of daily living.