Aarc Guideline: Intermittent Positive Pressure Breathing

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IPPB 2.0 DESCRIPTION/DEFINITION: The first American Association for Respiratory Care (AARC) clinical practice guideline (CPG) for Intermittent Positive Pressure Breathing (IPPB) was published in 1993. Since that time there have been additional studies, systematic overviews, and a meta-analysis that specifically addresses the eff icacy of IPPB as compared to other hyperinflation and aerosol delivery techniques.1 Those studies have been added as references to this revised CPG. IPPB remains a technique used to provide shortterm or intermittent mechanical ventilation for the purpose of augmenting lung expansion, delivering aerosol medication, or assisting ventilation.2 A caveat, however, is that IPPB is not the therapy of first choice for delivering aerosol or as a method of lung hyperinflation in spontaneously breathing patients when other less expensive therapies can reliably meet the clinical objectives prescribed for the p a t i e n t .1 , 3 1 2 It should be noted that noninvasive positive pressure ventilation (NPPV) may be considered as a form of IPPB to assist ventilation, although a review of this therapeutic modality was not included in this CPG. 2 . 1 IPPB can include pressureand time-limited, as well as pressure, time, and flow-cycled ventilation. 2.2 IPPB may be delivered to artificial airways and nonintubated patients.

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تاریخ انتشار 2003