The use of nebulized drugs and moisture by inhalation is well established in the management of patients with chronic airway obstruction.1-3 Inhalation therapy promotes bronchial hygiene. In principle, bronchial hygiene involves the inhalation of bronchodilator followed by the inhalation of moisture and in turn followed by the performance of expulsive coughing maneuvers or postural drainage to clear the lungs of retained secretions.3 Patients with severe airway obstruction and respiratory insufficiency are often limited in their ability to inhale nebulized bronchodilators because of their ventilatory impairment.1 These individuals need a device to perform the work of breathing during nebulization therapy. In addition, pressure breathing may be effective in relieving the work of breathing during intense dyspnea and thus allow for more rapid recovery from breathlessness than during spontaneous breathing. In the treatment of acute episodes of spasmodic bronchostenosis, intermittent positive pressure breathing (IPPB) therapy has been effective using
Petty TL, Broughton JO. A New, Simple IPPB Device for Hospital and Home Use. JAMA. 1968;203(10):871–874. doi:10.1001/jama.1968.03140100053011
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