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Lung Expansion Ther

Lung Expansion AKA Hyperinflation Therapy

QuestionAnswer
Lung expansion therapy is utilized to ? prevent or correct respiratory complications in the post-op period
Goals of Hyperinflation therapy are to improve oxygenation and ventilation ability and to maximize lung surface area (alveoli)
Name the 4 types of Atelectasis Resorption, Passive, Cyclical, and Fixed
Resorption atelectasis occurs when? mucus plugs block ventilation to selected regions of the lung and gas distal to obstruction is absorbed by passing blood
Causes of resorption atelectasis? pneumonia, chronic bronchitis..
Passive atelectasis is occurs from persistent breathing with small tidal volumes
Causes of Passive Atelectasis are surgery and pain medications
Cyclical Atelectasis is when alveoli pop open violently and close violently creating a crackle heard when auscultating
Cyclical atelectasis can cause increased inflammation and tearing of lung tissue
Fixed atelectasis is inability to inflate alveoli
What is heard during auscultating of a patient with fixed atelectasis bronchial/ diminished breath sounds (deep sound)
Factors associated with atelectasis are obesity, pregnancy, neuromuscular d/o, heavy sedation, surgery near diaphragm, bed rest, poor cough, and hx of lung disease
Clinical signs of atelectasis: Hx of recent major surgery, Tachypnea, Crackles, Bronchial/diminished breath sounds, Tachycardia, Increased density and signs of volume loss of chest xray
Incentive spirometry measures Vital capacity
Indications for IS are: atelectasis, post-op patients, presence of restrictive lung defect associated with quadriplegia and/or dysfunctional diphragm
The need for IS is determined by careful patient assessment (high risk patient)
Effective patient teaching: demonstrate then observe patient
Patient should sustain his or her maximal inspiratory effort for how long when using IS 5-10 seconds
Potential outcomes of Incentive Spirometry decreased RR, Normal Pulse rate, improved PaO2, decreased PCO2, Increased VC and PEFR, improved cough, increased FVC
Intermittent Positive Pressure Breathing uses positive airway pressure to expand the lung
Intermittent Positive Pressure Breathing treatments last 15-20 mins
What is passive during Intermittent Positive Pressure Breathing exhalation
Indications for IPPB patient with atelectasis not responsive to or cannot perform IS
Who are great candidates for IPPB trach patients
Contraindications to IPPB Tension pneumothorax, ICP>15mmHg, Hemodynamic instability, active hemoptysis, tracheoesophageal fistula, recent esophageal surgery, TB, Blebs on xray, recent facila/oral/skull surgery, hiccups, nausea, air swallowing
Another name for hiccups is Sigultus
Complications of IPPB Increased Raw, pulmonary barotrauma, nosocomial infections, resp alkalosis, hyperoxia, impaired venous return, gastric distension, air trapping/auto-PEEP/ overdistension, psych dependence
Potential outcomes of IPPB Improved VC, chest radiograph, breath sounds, oxygenation; increased FEV1 or peak flow; enhanced cough or secretion clearance
WHat are the 3 settings we adjust of the IPPB machine sensitivity, flow and pressure
What do we usually set the IPPB at before adjusting to the patients needs 15/15/15
The sensitivity setting on the IPPB machine is the patients energy/ strength triggers the machine to start
The flow setting on the IPPB machine drives the breath/gas and is set based on the desired flow/size
The pressure setting on the IPPB cycling mechanism- stops the breath and is set based on therapy
IPPB decreases perfusion
CPAP is continuous positive airway pressure
Indications for CPAP Tx of atelectasis, cardiogenic pulmonary edema
Contraindications for CPAP hemodynamic instability, hypoventilation, Obstructive sleep apnea (OSA)
Hazards/Complications of CPAP barotrauma, hypoventilation, gastric distention, vomiting and aspiration
The respiratory therapist shoudl evaluate the following before choosing a specific modality level of patient cooperation, amount of pulmonary secretions, and patient's spontaneous vital capacity
Created by: Dabi
 

 



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