Chapter 1 IPPB therapy Flashcards
spontaneous ventilation
muscle involve diaphragm
intercostal contracts
thoracic volumes expands
the pleural pressure becomes negative
visceral pleura form the outer layer of the lung parenchyma
the lungs expand as result of the transmural pressure
and pressure difference between the alveoli and the pleural space
As the transmural pressure becomes more negative
venous return improves deu to a greater pressure differential
venous return is passive resulting from muscle tone of muscle adjacent to veins
the decrease in transmural pressure assists in venous return
IPPB breathing is
assistance of mechanical ventilator that provides positive pressure during inspiration
IPPB affect on pleural pressure
it becomes more positive and positive pressure cause lungs to expand and movement of the cage is limited
affect on mediastinum
mediastinum is located between the lungs and positive pressure causes lungs to squeeze mediastinum and increase pressure with in mediastinum
effect on cardiopulmonary system
increases mediastinum pressure causes: decrease in venous return due to increase in pressure that venous system must now work to overcome
increase in intracranial pressure
decrease in the cardiac output may result hypotension
affect on the pulmonary system
increase pressure result increase tidal volume
greater transmural pressure are available to expand lungs
decrease work of breathing
IPPB can provide a decrease in the work of breathing
ventilator assist patient during inspiration , and relieving of muscle work
restoration of breathing pattern
careful manipulation of ventilator control can restore patient breathing pattern closer to normal
mechanical bronchodilation
the positive pressure of IPPB therapy result the dissension of the non-cartilaginous airway and this dilation is purely mechanical
improve/promote cough mechanism
increase the tidal volume to a level greater than is possible spontaneous
volume oriented IPPB: monitor TV and achieve greater than 100% of spontaneous IC and VC
improve distribution of ventilation
N2 studies indicate improvement in the disease patient
shown that when volume oriented is effective in reversal of atelectasis
deliver a medication
not a good indication
very expensive
and patient can take deep breath use and mdi and dpi
clinical indication
vc<15 ml/kg acute hypoventilation chronic hypoventilation weaning atelectasis clear secretion or promote cough Acute Resp Distress
Contraindication of IPPB
absolute: untreated pneumothorax Relative contraindication: hemoptysis sucutaneous or mediastinal air TE fistula Bullous emphysema cardiovascular insufficeincy subjective deterioration availability of simpler therapy
hazard and complication
decrease in arterial CO2 excessive ventilation Sign and symptoms: light headed dizzy faint
decrease cardiac output
result of positive intathoracic pressure
and decreased BP
increase intracranial pressure
cause by increase intrathoracic pressure
gastric insufflation
ramming air down into gut
interruption of hypoxic drive
used compress air for CO2 retainer
fighting machine
improper technique and poor interaction
can cause a pneumothorax with bullous disease
