Abstract
The increase of the inflationary lung volume created by a respiratory maneuver is critical for preventing postoperative alveolar collapse. We measured this volume as achieved with IPPB or incentive spirometry (IS) in 20 post-operative surgical patients. Using IPPB, with gas flow and peak airway pressures carefully adjusted for each patient, a value of 2240±630 cc (mean±1 SD) was obtained compared to 1960±650 cc with IS. This difference is highly significant (p<0.0005 by the Wilcoxon test).
We conclude that IPPB, by careful application, and with monitoring of tidal volumes, is likely to provide better prophylaxis of postoperative pulmonary complications, particularly in patients with compromised lung function and in an intensive care unit, where enough trained personel are available.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Anderson, W.H., et al.: Prevention of postoperative pulmonary complications. J. Amer. med. Ass.186, 763 (1963)
Barach, A.L., Segal, M.S.: The indiscriminate use of IPPB. J. Amer. med. Ass.231, 1141 (1975)
Bartlett, R.H., et al: The physiology of yawning and its application to postoperative care. Surg. Forum21, 222 (1970)
Bartlett, R.H., et al: The yawn mancuver. Surg. Forum22, 196 (1971)
Bartlett, R.H., et al: Respiratory maneuvers to prevent post-operative pulmonary complications. A critical review. J. Amer. med. Ass.224, 1017 (1973)
Bartlett, R.H., et al: Studieson the pathogenesis and prevention of postoperative pulmonary complications. Surg. Gynec. Obstet.137, 925 (1973)
Baxter, W.D., Levine, R.S.: An evaluation of intermittent positive pressure breathing in the prevention of postoperative pulmonary complications. Arch. Surg.98, 795 (1969)
Becker, A., et al: The treatment of postoperative pulmonary atelectasis with intermittent positive pressure breathing. Surg. Gynec. Obstet.111, 517 (1960)
Bryant, L.R.: Intermittent positive pressure breathing. J. thorac. cardiovasc. Surg.59, 303 (1970)
Craven J.L., et al: The evaluation of the incentive spirometer in the management of postoperative pulmonary complications. Brit. J. Surg.61, 793 (1974)
Froese, A.B., Bryan, A.C.: Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology41, 242 (1974)
Gold, M.I.: Is intermittent positive pressure breathing therapy (IPPB RX) necessary in the surgical patient? Ann. Surg.184, 122 (1976)
Mc Connell, D.H., et al: Postoperative intermittent positive pressure breathing treatments. J. thorac. cardiovasc. Surg.68, 944 (1974)
Milic-Emili, J., et al: Regional distribution of inspired gas in the lung. J. appl. Physiol.21, 749 (1966)
Noehren, T.H.: IPPB therapy-where do we go from here? Chest67, 471 (1975)
Petty, T.L.: A critical look at IPPB. Chest66, 1 (1974)
Sands, J.H., et al: A controlled study using routine intermittent positive pressure breathing in the post-surgical patient. Chest40, 128 (1961)
Van de Water, J.M., et al: Prevention of postoperative pulmonary complications. Surg. Gynec. Obstet.135, 229 (1972)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pfenninger, J., Roth, F. Intermittent positive pressure breathing (IPPB) versus incentive Spirometer (IS) therapy in the postoperative period. Intensive Care Med 3, 279–281 (1977). https://doi.org/10.1007/BF01641120
Issue Date:
DOI: https://doi.org/10.1007/BF01641120