The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

CLINICAL COMPARISON OF TWO IPPB DEVICES: PIPER-IPPB® & BIRD® IPPB

Mario Romano, RCP, Mercy General Hospital, Medical Intensive Care Unit, Sacramento, CA, USA

BACKGROUND: Intermittent Positive Pressure Breathing (IPPB) is a technique used to provide short-term or intermittent mechanical ventilation to augment lung expansion, deliver aerosol medication, or assist ventilation[1] for the treatment of atelectasis. The use of IPPB to provide large inspiratory volumes when patients cannot take deep breaths has been found to be beneficial in the management of atelectasis where other approaches have failed[2]. Since the BirdÒ IPPB is no longer being manufactured, the shortage of spare parts makes it difficult to maintain existing units. This study compares a new single patient use IPPB device, the Piper-IPPBTM (VORTRAN Medical Technology 1), with the conventional IPPB - BirdÒ Mark 7Ò Positive Phase Medical Respirator (Bird Corporation).

Methods: Two clinically stable female patients, one with COPD and one with CHF (ages 72 and 74), received 10 minutes of the Bird IPPB and the Piper-IPPB in alternate therapy sessions. Each treatment included 0.5 cc albuterol (2.5 mg), unit dose ipartropium bromide (0.5 mg), and 10 cc normal saline. A compressed gas source was used for both devices and pulse oximetry (O2 Sat.), heart rate (HR), blood pressure (BP), and breath sounds (BS) were monitored before and after each therapy session.

Results: Patients' vital signs are summarized below:

Dx COPD CHF
Devices Piper-IPPBTM BirdÒ IPPB Piper-IPPBTM BirdÒ IPPB
PIP Set 20 cm-H2O 15 cm-H2O 25 cm-H2O 25 cm-H2O
FiO2 Set Room air Room air 100% O2 100% O2
Tx Pre Post Pre Post Pre Post Pre Post
O2 Sat. 93 93 94 93 93 99 93 98
HR 92 90 100 101 105 103 104 107
BP 136/6 128/6 141/7 142/7 148/4 154/5 139/4 151/4
7 4 0 0 5 0 6 9
BS Crackle at bases Diminished at bases

DISCUSSION: One patient reported that the work of breathing was easy and that the inspiratory flowrate was just right for both devices. The other patient reported that the inspiratory flowrate for both IPPBs was too slow and that the work of breathing for Piper-IPPB was slightly harder. No significant changes in vital signs were noted with either device. Both patients found the Piper-IPPB easy to use and preferred it to the conventional Bird-IPPB.

Conclusions: The Piper-IPPB can be a safe and effective method of delivering IPPB treatment without the need for conventional IPPB capital equipment. Using a larger patient population in a future study can help establish the Piper-IPPB as a safe and effective treatment modality.

Supported by VORTRAN Medical Technology 1, Inc.

[1] Agency for Health Care Policy and Research (AHCPR). Health Technology Report: Intermittent Positive Pressure Breathing (IPPB) Therapy. 1991, Number 1.

[2] Walter J. O'Donohue, Jr., M.D., F.C.C.P.: Maximum Volume IPPB for the Management of Pulmonary Atelectasis, Chest, December 1979, 76:6, 683-687.

OF-99-100

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