intermittent positive-pressure breathing

intermittent positive-pressure breathing (IPPB),

a form of assisted or controlled respiration produced by a ventilatory apparatus 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, and the cycle begins again as the flow of gas is triggered by inhalation. Also called IPPV (intermittent positive-pressure ventilation).

method The use of the IPPB unit involves the combined efforts of the physician, the respiratory therapist or technician, and the nurse. The specific pressure and volume and the use of nebulizing or other attachments are ordered individually. The equipment is tested and introduced to the patient by the respiratory therapist. The nurse observes that the patient closes the lips around the mouthpiece and does not allow air to escape from the nose or mouth during inspiration and determines whether the therapy is effective. Exhaled tidal volume is measured, with a goal of achieving 10-15 mL/kg of body weight.

interventions The patient may require reassurance that the machine will automatically shut off airflow at the end of inspiration and encouragement to relax and allow the lungs to be completely filled by the machine. The patient is cautioned not to manipulate any of the controls.

outcome criteria Ventilation may be greatly improved by the use of the IPPB unit. Secretions may be thinned and cleared, and the passages may be humidified, allowing greater comfort and a better exchange of gases.