IPPB definition etc

• IPPB:

  • aka ‘The Bird’
  • Adjunct to airway clearance – it is a physiotherapy treatment adjunct
  • Should be considered if other techniques are not effective
  • Provides inspiratory positive pressure
  • Pressure cycled
• Physiological Effects:

  • Increase in tidal volume
  • Decrease in Work of breath because:
  • minimal inspiratory effort required by the patient
  • offloads inspiratory muscles
• Clinical Indication:

  • Aids sputum clearance – by recruiting collateral channels, air can get behind sputum and push it out via expiration
  • Helps to recruit atelectatic lung – air reaches lung via collateral channels, interdependence of alveoli - chain of alveoli inflating
  • Breathless patients
  • decrease in work of breath - decreasing work of inspiratory muscles by providing pressure
  • can administer nebulisers (drugs) at the same time
• Mouthpiece or Mask?

  • Usually used with a mouthpiece
  • flange mouthpiece - people grip with teeth but is clamped in mouth
  • facemasks - cant be used with children

  
• IPPB Technique:

  • Used during lower thoracic expansion phase of ACBT if sputum clearance or lung recruitment is the aim
  • Can use with manual techniques
  • Position with affected lung uppermost (top side)
  • gravity assisted positioning
  • Increased ventilation to non-dependent lung
• Positive Pressure Precautions (i.e. IPPB and CPAP) - Precautions / Contraindications:

  • undrained pneumothorax - air in pleural cavity
  • large bullae - present in emphysema
  • proximal tumour
  • severe haemoptysis - coughing up blood
  • persistent air leak post thoracic surgery