Why/How Often for Lung Therapy

Question 1

Incentive Spirometry (IS)

Answer 1

Indications:
-Pulmonary Atelectasis
-Upper Abdominal Surgery
-Thoracic Surgery
-Surgery in COPD pts
-Restrictive lung disease with quadriplegia or -dysfunctional diaphragm
How Often:
5-10 times per hour as tolerated

Question 2

Intermittent Positive Airway Pressure Breathing (IPPB)

Answer 2

Indications: 
-Improve lung expansion
-Pulmonary Atelectasis
-Inability to clear secretions
-Short term Ventilatory Support
-Deliver Aerosol medication
-Severe Hyperinflation
How Often:
Every 1 to 6 hours as tolerated

Question 3

Continuous Positive Airway Pressure (CPAP)

Answer 3

Indications:
-Postoperative Atelectasis
-Pulmonary Edema
-CHF
How Often:
Continuous basis until the patient recovers. Vitals need to be closely monitored

Question 4

Positive Airway Pressure (EZPAP)

Answer 4

Indications:
-Expiratory airflow limitations
-Pulmonary Atelectasis 
-Breathlessness
-IS ineffective 
How Often:
Just a few minutes of therapy, as needed - not for hours at a time.

Question 5

Positive Expiratory Pressure (PEP)

Answer 5

Indications:
-To reduce air trapping in asthma and COPD
-To aid in mobilization of retained secretions
-To prevent or reverse atelectasis
-To optimize delivery of bronchodilators
How Often:
Two to four times daily

Question 6

Exsufflation Machine (Cough Assist)

Answer 6

Indications:
-Unable to clear secretions effectively
-Peak cough flows of <180 L/min are unlikely to be effective at clearing secretions.
-Can be useful in preventing respiratory complications due to secretion retention and poor tidal volumes.
How Often:
four times per day, but it can be used as frequently as once an hour