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Definition

 IPPB is a short-term breathing treatment

in which pressures above atmospheric
pressure are delivered to the pt’s lungs via
a pressure-cycled ventilator. Usually the
machine is a pneumatically powered
machine.

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Pressure Graphs
IPPB CPPB

PEEP NEEP

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 Physiology

 Increase in mean airway pressure

 Decrease in work of breathing
 Manipulate the I:E ratio
 Increase in tidal volume
 Mechanical bronchodilation
 Secretion Control
 Cerebral blood flow alteration

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 Clinical Goals

 Prevent or correct atelectasis

 Improve and promote the cough
mechanism
 Decrease the work of breathing
 Deliver medications

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 Indications

 Acute or chronic hypoventilation

 Atelectasis
 Reduced cough effort
 Increased airway resistance
 Increased work of breathing
 Accumulation of secretions
 Pulmonary congestion

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 Hazards of IPPB Therapy

 Hyperventilation
 Decreased cardiac output
 Barotrauma (volutrauma)
 Oxygen-induced hypoventilation
 Bronchospasms
 Contamination
 Gastric Distension

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 Hazards of IPPB Therapy

 Hemoptysis
 Increased intracranial pressure
 Psychological dependence
 Air trapping
 Uncooperative patient

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 Contra-indications

 Untreated pneumothorax
 Pulmonary hemorrhage
 Relative contra-indications

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 Assessing the needs for IPPB

 Physiologic/pathologic
 Contraindications?
 Cooperativeness of the patient
 Special needs of the patient
 Effects of prescribed medicines
 Economics
 Educated personnel

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 Effectiveness of therapy

 Breath sounds
 PEFR
 ABG’s
 Clinical Appearance
 sputum

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 Written Order
 What should be included?

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 Instructions!!!
 What are they? Is IPPB active or passive?

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 I:E Ratios
 Given Vt = 750 cc, RR=10, PF=25 lpm,
what is the I:E ratio Given Vt = 800cc,
RR=15, I:E 1:3, what is the peak flow?
Given RR=10, I:E 1:2, PF = 25 lpm, what
s the Vt? Given Vt = 900 cc, PF=54 lpm,
I:E 2:3, what is the RR?

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