Intermittent positive pressure breathing

As an emergency treatment, the washing of the contaminated body parts with a 5% thiosulfate solution is recommended. If swallowed, gastric lavage with 5% solution of thiosulfate, followed by saline catharsis should be accompHshed. If pulmonary signs are severe, oxygen should be suppHed with intermittent positive-pressure breathing apparatus. 

IPPB intermittent positive pressure breathing PBI protein-bound iodine... 

Chapter 13. It also is used in some countries as a sedative-hypnotic drug in intensive care units, during intermittent positive-pressure breathing, in epidural anesthesia, and in other situations. 

Preventive measures to reduce the risk of NP include maintaining semiupright patient position to reduce aspiration, frequent coughing, chest physiotherapy, and early ambulation to prevent atelectasis and retained secretions. Deep breathing exercises, incentive spirometry, and intermittent positive pressure breathing (IPPB) may benefit patients with underlying pulmonary dysfunction. Effective pain control also facilitates coughing and the expectoration of aspirated secretions (2). 

Baxter WD, Levine RS. An evaluation of intermittent positive pressure breathing in the prevention of postoperative pulmonary complications. Arch Surg 1969 98 795-798. 

Nebulized aerosol is introduced to the patient by compressed air, either from a constant source or from a device known as intermittent positive-pressure ventilator. Nebulized aerosols rely less on the patient s own breathing pattern. Under some circumstances the dose administered to the patient by nebulizer is inconsistent or unpredictable. In a hospital setting, the aerosol administration can be supervised by qualified individuals. Home administration is not always supervised, and there is, therefore, a potential for misuse. 

Fig. 24. The effects of intermittent positive pressure ventilation (IPPV) on plasma GST Bj concentrations in patients receiving halothane or isofiurane anesthesia. A total of 60 patients were studied 28 were ventilated (14 halothane, 14 isofiurane) and 32 breathed spontaneously (14 halothane, 18 isofiurane). An asterisk signifies a p<0.05 increase from the basal levels.

Patients with moderate to severe pulmonary disease requiring vascular access surgery will benefit most from a LRA technique. General anesthesia (GA) with intermittent positive pressure ventilation (IPPV) and use of muscle relaxants impairs respiration more than LRA with maintained spontaneous breathing. IPPV may cause dynamic overinflation or barotrauma to lungs, promote atelectasis and impair mucociliary clearance [7]. This may be associated with increased pulmonary morbidity, prolonged hospital stay, resource utilization and cost. 

The use of MI-E has been demonstrated to be very important in extubating NMD patients following general anesthesia, despite their lack of any breathing tolerance, and managing them with NIV (8,9,60). It is also permitted to avoid intubation or to quickly extubate NMD patients in acute ventilatory failure with no breathing tolerance and profuse airway secretions due to intercurrent chest infections (37,83,84). MI-E in a protocol with manually assisted coughing, oximetry feedback, and home use of noninvasive intermittent positive pressure ventilation was shown to effectively decrease hospitalizations and respiratory complications, and mortality for patients with NMD (7,85). 

Figure 3 A 51-year-old man with ALS and no ventilator-free breathing ability using daytime mouthpiece IPPV. Abbreviations ALS, amyotrophic lateral scoliosis IPPV, intermittent positive pressure ventilation.

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