ppt课件-alternativestoippbatutorial-kingwoodapplicationserver.pptVIP

Reference page Egan’s page: 877-881 ezPAP web pages PEP device web pages McPherson’s Respiratory Care Equipment Sill’s “Respiratory care Registry guide” Alternatives to IPPB: a tutorial By Elizabeth Kelley Buzbee AAS, RRT-NPS, RCP IPPB As we know, IPPB is the application of an IC [inspiratory capacity] via application of positive pressure sent into the lung with an inline SVN, so that both IC and drugs are delivered to the lung of a person who cannot take a deep enough breath spontaneously to distribute alveolar ventilation and medication to the periphery of the lung Problems with IPPB The machines are fairly complex, break down easily and the patient has to learn some fairly complex skills to optimize his therapy. The hazards of IPPB are associated with the hazards of any form of positive pressure: barotrauma and interference with the cardiovascular system being the worst Alternatives to IPPB Over the last few years, as IPPB has wained in popularity other forms of hyper –inflation have evolved. Obviously, IS is one of these forms of hyperinflation, but we will discuss a few, more invasive forms of hyperinflation today PAP PAP: Positive Airway Pressure: advantage is that it easier to do than IPPB; some methods don’t even require a 02 source. Application of Positive Airway pressure can take several forms: CPAP EPAP PEP ezPAP Retard valve [not really an alternative, but added to the IPPB] We will discuss each of these 4 methods CPAP CPAP constant positive airway pressure breathing. The pressure base line is raised from zero to a positive number. The CPAP has only one parameter and that is the baseline pressure. CPAP 5 means the baseline has risen to 5 cmH20. The patient breathes spontaneously on this higher baseline pressure. For example: you normally breathe between -5 to zero. On IPPB you may alternate between -2 and +15, but with CPAP 5, you are breathing +3 to + 5. CPAP While there are a variety of methods that CPAP can be created, essentially in CPAP