Respiratory therapy techniques

2019 ◽  
pp. 1-54
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Respiratory Therapy ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
High Frequency Ventilation ◽  
Chest Drain ◽  
Frequency Ventilation ◽  
Positive Airway Pressure Ventilation ◽  
Pressure Release Ventilation

This chapter discusses respiratory therapy techniques and includes discussion on oxygen therapy, discussion of intermittent positive pressure ventilation and description of ventilators, modes of ventilation, adjusting the ventilator, barotrauma, and weaning techniques. The chapter also discusses high-frequency ventilation, airway pressure release ventilation, as well as positive end-respiratory pressure, continuous positive airway pressure ventilation, recruitment manoeuvres, prone position ventilation, non-invasive positive pressure ventilation, extracorporeal membrane oxygenation, cricothyroidotomy, tracheostomy, aftercare of the patient with a tracheostomy, chest drain insertion, pleural aspiration, flexible bronchoscopy, chest physiotherapy, humidification, and heart–lung interactions.

The Physiology and Biophysics of Respiratory Therapy

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
J. Scott Turner
Keyword(s):  
Lung Injury ◽  
High Frequency ◽  
Positive Pressure Ventilation ◽  
Artificial Ventilation ◽  
Respiratory Therapy ◽  
Effective Alternative ◽  
Positive Pressure ◽  
High Frequency Ventilation ◽  
Frequency Ventilation ◽  
Fatal Complications

Artificial ventilation carries a suite of risks, including ventilation-induced pneumonia, permanent lung injury, and fatal complications. It is a drastic and dangerous intervention in a patient’s care. J. Scott Turner explores why high-frequency ventilation may be a safer and more effective alternative to the positive-pressure ventilation that is most commonly used in severe COVID-19 cases.

scholarly journals Physiological Aspects of Intermittent Positive Pressure Ventilation

1986 ◽  
Vol 14 (3) ◽  
pp. 226-235 ◽  
Author(s):  
D. R. Hillman
Keyword(s):  
Gas Exchange ◽  
Positive Pressure Ventilation ◽  
Volume Flow Rate ◽  
Lung Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Rational Approach ◽  
Positive Pressure ◽  
High Frequency Ventilation ◽  
Potential Hazard ◽  
Frequency Ventilation

The mechanical properties of the lungs and chest wall dictate the relationship between tidal volume, flow rate and airway pressure developed during intermittent positive pressure ventilation (IPPV). The increase in intrathoracic pressures associated with IPPV has consequences for the intrapulmonary distribution of ventilation and perfusion (hence gas exchange), cardiac output and regional blood flows. Barotrauma is a potential hazard. IPPV also affects the homeostatic mechanisms that keep the air spaces dry. Strategies to maximise the benefits and minimise the side effects of IPPV include positive end-expiratory pressure, intermittent mandatory ventilation, differential lung ventilation and high frequency ventilation. Understanding the physiological effects of IPPV and associated therapies allows a rational approach to the adjustment of ventilation against pulmonary, cardiovascular and systemic responses so as to optimise gas exchange and peripheral oxygen delivery.

Nasal Intermittent Positive Pressure Ventilation versus Continuous Positive Airway Pressure and Apnea of Prematurity: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Bayane Sabsabi ◽  
Ava Harrison ◽  
Laura Banfield ◽  
Amit Mukerji
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Primary Outcome ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Apnea Of Prematurity

Objective The study aimed to systematically review and analyze the impact of nasal intermittent positive pressure ventilation (NIPPV) versus continuous positive airway pressure (CPAP) on apnea of prematurity (AOP) in preterm neonates. Study Design In this systematic review and meta-analysis, experimental studies enrolling preterm infants comparing NIPPV (synchronized, nonsynchronized, and bi-level) and CPAP (all types) were searched in multiple databases and screened for the assessment of AOP. Primary outcome was AOP frequency per hour (as defined by authors of included studies). Results Out of 4,980 articles identified, 18 studies were included with eight studies contributing to the primary outcome. All studies had a high risk of bias, with significant heterogeneity in definition and measurement of AOP. There was no difference in AOPs per hour between NIPPV versus CPAP (weighted mean difference = −0.19; 95% confidence interval [CI]: −0.76 to 0.37; eight studies, 456 patients). However, in a post hoc analysis evaluating the presence of any AOP (over varying time periods), the pooled odds ratio (OR) was lower with NIPPV (OR: 0.46; 95% CI: 0.32–0.67; 10 studies, 872 patients). Conclusion NIPPV was not associated with decrease in AOP frequency, although demonstrated lower odds of developing any AOP. However, definite recommendations cannot be made based on the quality of the published evidence. Key Points

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