Intermittent Positive-Pressure Breathing - Noninvasive Respiratory Therapies

INTERMITTENT POSITIVE-PRESSURE BREATHING

Intermittent positive-pressure breathing (IPPB) is a form of as-sisted or controlled respiration produced by a ventilatory appara-tus in which compressed gas is delivered under positive pressure into a person’s airways until a preset pressure is reached. Passive exhalation is allowed through a valve. The specific pressure and volume amounts, along with the use of any nebulizing medica-tions, are prescribed individually for patients. The nurse should encourage patients to relax and reassure them that the machine will automatically shut off airflow at the end of inspiration. The IPPB machine may be powered by electricity or gas and may be connected with a mouthpiece, mask, or tracheostomy adapter.

Indications

General indications for IPPB include difficulty in raising respira-tory secretions, reduced vital capacity with ineffective deep breathing and coughing, or unsuccessful trials of simpler and less costly methods for loosening secretions, delivering aerosol, or ex-panding the lungs.

Complications

IPPB therapy is used rarely today because of its inherent hazards, which may include pneumothorax, mucosal drying, increased intracranial pressure, hemoptysis, gastric distention, vomiting with possible aspiration, psychological dependency (especially with long-term use, as in COPD patients), hyperventilation, ex-cessive oxygen administration, and cardiovascular problems.