Intermittent Positive Pressure Breathing

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Intermittent Positive Pressure Breathing
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What is IPPB?

• A mechanical device that assists patients to take
  deeper breaths, and control lung inflation by
  increasing the lung pressure during one breathing
  cycle.
• It creates a positive pressure at the opening of
  the airway, causing gas to flow into the lungs,
  and resulting in an increase in tidal volume, a
  decreased WOB, and an increase in minute
  ventilation.

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What Patients Will Benefit From IPPB?

• Patients whose depth of breathing is limited.
• IPPB is most often effective in treating
  atelectasis.
• Treatment should increase patients depth of
  breathing more than they can achieve alone.

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PROPER INSTRUCTION IS THE KEY!!

• A well-trained RT should have knowledge of the
  equipment, medications used, reasons for using
  the therapy, side effects, and goals of the
  therapy.
• Patient must remain cooperative
• Proper instructions must be given regarding
  breathing patterns, cough techniques, and what
  the patient is expected to experience during a
  procedure.

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Monitoring Adverse Effects

• The flow rate is set too high.
• The patient is stopping the flow with their
  tongue or by exhaling prematurely instead of
  allowing the machine to inhale for them.

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Efficacy

• A large body of literature has been published
  opposing the efficacy of the use of IPPB in
  different patient populations.
• It may be that the use of IPPB should be used
  with a combination of techniques.
• Periodic lung hyperinflation in the early stages
  of certain pathological conditions may alter the
  natural history of the condition and reduce
  pulmonary complications.

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The Bottom Line

• IPPB continues to be used in both inpatient and
  outpatient settings.
• The lack of teaching hospitals may be a
  significant factor in the decline use of this
  treatment.
• IPPB still has a role in the management of
  patients with reduced lung volumes.