Pulmonary complications, notably atelectasis and pneumonitis, continue to complicate the postoperative course of 5% to 72% of patients undergoing upper abdominal surgery.1-7 Intermittent positive pressure breathing (IPPB) has been widely advocated as a means of reducing this incidence,8-13 but there is disagreement as to its effectiveness.14
St. Mary's Hospital is a 400-bed community hospital with an established Department of Inhalation Therapy. The department is under the supervision of an internist with special interest and training in pulmonary disease and inhalation therapy. The technicians who administer IPPB treatments to the patient have a wide variety of educational backgrounds and undergo an initial three- to four-week period of on-the-job training, as well as a departmental program of continuing education in the field of inhalation therapy.
The availability of this talent engendered great enthusiasm among the surgical staff for the use of IPPB in the postoperative patient to reduce the