Intermittent positive pressure breathing (IPPB) is a

respiratory therapy A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respirato ...

treatment for people who are hypoventilating. While not a preferred method due to cost, IPPB is used to expand the lungs, deliver aerosol medications, and in some circumstances ventilate the patient. __TOC__

Indications

IPPB may be indicated for patients who are at risk for developing

atelectasis Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct ...

and who are unable or unwilling to breathe deeply without assistance. In patients with severe lung hyperinflation, IPPB may decrease

dyspnea Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...

and discomfort during nebulized therapy.

Contraindications

Most contraindications are relative, such as nausea,

hemodynamic Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously mo ...

instability,

tracheal The trachea, also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all air-breathing animals with lungs. The trachea extends from the la ...

fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

singulation Singulation is a method by which an RFID reader identifies a tag with a specific serial number from a number of tags in its field. This is necessary because if multiple tags respond simultaneously to a query, they will jam each other. In a typic ...

and

hemoptysis Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, a ...

. Untreated

tension pneumothorax A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve i ...

is an absolute contraindication. 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

{{reflist Respiratory therapy