Medicine:Intermittent positive pressure breathing
| Intermittent positive pressure breathing | |
|---|---|
| Specialty | pulmonology |
Intermittent positive pressure breathing (IPPB) is a respiratory therapy treatment for people who are hypoventilating. While not a preferred method due to cost,[1] IPPB is used to expand the lungs, deliver aerosol medications, and in some circumstances ventilate the patient.[2]
Indications
IPPB may be indicated for patients who are at risk for developing atelectasis and who are unable or unwilling to breathe deeply without assistance.[3] In patients with severe lung hyperinflation, IPPB may decrease dyspnea and discomfort during nebulized therapy.[4]
Contraindications
Most contraindications are relative, such as nausea, hemodynamic instability,[5] tracheal fistula, singulation and hemoptysis.[6] Untreated tension pneumothorax is an absolute contraindication.[7]
IMPLEMENTATION
When treating atelectasis -
- Therapy should be volume-oriented
2. Tidal volumes(VT) must be measured
3. VT goals must be set
4. VT goal of 10-15mL/kg ofbody weight
5. Pressure can be increased to reach VT goal if tolerated by patient.
When treating atelectasis, IPPB is only useful in the treatment of atelectasis if the volume delivered exceeds those volumes achieved by the patient's spontaneous efforts.
References
- ↑ "Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercises effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A systematic overview and meta-analysis". Phys Ther 74 (1): 3–16. 1994. doi:10.1093/ptj/74.1.3. PMID 8265725.
- ↑ Handelsman H (1991). "Intermittent positive pressure breathing (IPPB) therapy". Health Technology Assessment Reports (1): 1–9. PMID 1810351.
- ↑ "Patient assessment and respiratory care plan development.". Critical thinking in respiratory care. New York: McGraw-Hill. 2001. ISBN 978-0-07-134474-6.
- ↑ "Management of dyspnea in severe chronic obstructive pulmonary disease". J Pain Symptom Manage 19 (5): 378–92. 2000. doi:10.1016/S0885-3924(00)00129-9. PMID 10869878.
- ↑ "Intermittent positive pressure breathing: a continuing controversy". J Iowa Med Soc 70 (3): 99–100, 102–103. 1980.
- ↑ "Complications of mechanical aids to intermittent lung inflation". Respir Care 27 (4): 467–70. 1982.
- ↑ Egan's fundamentals of respiratory care (7th ed.). St. Louis: Mosby. 1999. pp. 777–782.
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