IPPB Flashcards
what does IBBP stand for
intermittent positive pressure breathing
how long do you do IBBP for
15-20 minutes - short term
how is the machine powered
pneumatically powered machine
what happens to the alveoli due to IBBP treatment
increase in size bc of positive pressure
what are the clinical goals of IPPB
need to improve lung expansion, need for short term ventilator support for hypercapnic patients, deliver medications
physiology of IPPB
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
indications of IPPB
acute or chronic hypoventilation, atelectasis, reduced cough effort, increased RAW, increased WOB, accumulation of secretions, pulmonary congestion/edema
what is an absolute contraindication of IPPB
untreated tension pneumothorax
hazards of IPPB
increased RAW, WOB, hemoptysis, psychological dependence, increased V/Q mismatch, air trapping, pneumothorax, bronchospasm, gastric distension, impede venous return, 02 induced hypoventilation, hyperventilation
relative contraindications of IPPB
active hemoptysis, increased intercranial pressure >15 mmHg, hiccups, tracheoesophageal fistula, uncooperative patient, any facial/skull trauma, untreated active TB, blebs, hemodynamic instability
effectiveness of therapy
tidal volume increased by more than 25%, breath sounds improved, PEFR/FEV1 increased, ABG improvement, secretion clearance increase, more effective cough, better x-ray evidence
how does IPPB start
when it is triggered for sensitivity b/w -2 and -5 cmh2o
how do you set the flow rate
watching pressure gauge and talking to the patient
what do you set the pressure at
according to the prescribed tidal volume - 10 to 15 ml/kg ideal body weight and always below 20 cmh2o
what happens when you increase sensitivity
the magnet is further away so it takes less breath to start the cycle and makes it easier
`how do you increase pressure
have the magnet closer to the disk its harder because you have to break them apart
how do you create volume
you create volume by increasing the pressure
what will happen if the machine is too sensitive
it will autocycle to quickly and the magnet is to far away from the plate
what will happen if the machine is to difficult
pt cant trigger and the manameter will swing negative but nothing will happen
how can you tell if a patient is trying to breath with the machine
the manometer will have pressure jumps
what does IPPB make the inspiration pressure become
positive instead of negative pressure
when is the breath terminated
when the predetermined inhalation pressure is reached and then the patient can exhale
what is the mean airway pressure
average of both pressures on exhalation and inhalation
