Disease relevance of Intermittent Positive-Pressure Ventilation

• BACKGROUND--There are no controlled trials of the use of different modes of nasal intermittent positive pressure ventilation (NIPPV) in patients with exacerbations of chronic obstructive pulmonary disease (COPD) [1].
• Repeating Group 2 studies after induction of oleic acid low-pressure pulmonary edema demonstrated that conventional IPPV was associated with large intrapulmonary shunts [2].
• An infusion of atracurium was used (after an initial bolus dose) in five patients with renal and respiratory failure, who were being subjected to intermittent positive pressure ventilation before renal dialysis [3].
• Avoidance of intermittent positive pressure ventilation in tetanus with dantrolene therapy [4].
• A case of status epilepticus. Use of thiopentone and IPPV to control otherwise refractory convulsions [5].

High impact information on Intermittent Positive-Pressure Ventilation

• In addition, infants who required IPPV or HFOV had significantly lower serum cortisol at d 7 (P < 0.0001), but this pattern of cortisol response was reversed on d 14, with infants requiring IPPV or HFOV having significantly higher serum cortisol (P < 0.036) [6].
• Levels of IL-8 in BLF at 14 days of age correlated with the long term requirement for intermittent positive pressure ventilation (IPPV) [7].
• In vitro validation was done by methanol burning (VO(2), 13.8 mL/min; VCO(2), 9.2 mL/min) during intermittent positive pressure ventilation (IPPV) with two commonly used ventilators (Sechrist IV-100B and Infant Star) [8].
• Median IL-8 values (nanograms/mg of SC) were 671, 736, 705, 1362, and 1879 (IPPV) and 874, 1713, 1029, 1426, and 1823 (HFOV), respectively, and median LTB4 values (nanograms/mg of SC) were 26, 13, 27, 22, and 11 (IPPV) and 15, 12, 7, 12, and 16 (HFOV), respectively [9].
• The average exposure to O2 after betamethasone was 12.7 days v 20.2 days, (P = .01), although need for intermittent positive pressure ventilation was similar (23 days) in the two groups [10].

Chemical compound and disease context of Intermittent Positive-Pressure Ventilation

• The nocturnal delivery of intermittent positive-pressure ventilation resulted in normalization of oxyhemoglobin saturation and end-tidal CO2 and alleviation of symptoms of alveolar hypoventilation [11].
• The effects of 70% nitrous oxide, added to 1% end-tidal isoflurane and administered by intermittent positive pressure ventilation (IPPV), on coronary haemodynamics and myocardial oxygenation were investigated in 10 patients with ischaemic heart disease [12].
• Of the 197 infants 121 (61%) were treated with intermittent positive pressure ventilation, 83 (42%) with dopamine for hypotension, and 92 (47%) received parenteral nutrition [13].
• Metaproterenol (15 mg) and albuterol (5 mg) solutions were each nebulized and delivered to 20 patients with reversible airway obstruction utilizing intermittent positive pressure ventilation in a double-blind comparison [14].
• Intermittent positive pressure ventilated (IPPV) pigs under chlormethiazole anaesthesia were infused with E. coli endotoxin (18 micrograms.kg-1.h-1) over 4 h [15].

Biological context of Intermittent Positive-Pressure Ventilation

• The effects of acute changes in arterial carbon dioxide and oxygen tension, produced by altering the inspired gas mixtures while maintaining constant-volume intermittent positive pressure ventilation, on global function, regional left ventricular function, and coronary hemodynamics were studied in eight sheep during halothane anesthesia [16].
• They received standardized anaesthesia with fentanyl, 50% nitrous oxide in oxygen and isoflurane; monitoring included radial and fibreoptic pulmonary arterial catheters and intermittent positive pressure ventilation with a tidal volume of 8 ml kg-1, 16 bpm, and an I:E ratio of 1:2 [17].
• We have examined the effects on the cardiovascular system and on regional blood flow of propofol and thiopentone when administered with IPPV (FIO2 0.4) [18].
• Stroke volume measured during steady-state isoflurane anaesthesia and IPPV with preload, afterload, and heart rate kept constant was 23% below awake control [19].
• CONCLUSION: During IPPV, pressure in the breathing circuit is lower during exhalation, thus allowing air to enter through the slit-like hole in the sampling tube causing erroneously low ETCO2 and expiratory sevoflurane [20].

Anatomical context of Intermittent Positive-Pressure Ventilation

• During isoflurane anaesthesia, femoral arterial blood flow was significantly higher in both pelvic limbs compared with halothane anaesthesia, and flow in the lower limb was significantly higher during spontaneous ventilation than during IPPV [21].
• We have investigated the contribution of changes in respiratory muscle strength, the ventilatory response to CO2 and ventilatory function to changes in arterial blood gas tensions in eight patients with severe COPD completing six months domiciliary nasal intermittent positive pressure ventilation [22].

Associations of Intermittent Positive-Pressure Ventilation with chemical compounds

• Addition of 1% halothane increased blood flow to the atelectatic left lung during unilateral ventilation with IPPV but not with HFPPV [23].
• Arterial to end-tidal CO2 gradients during spontaneous breathing, intermittent positive-pressure ventilation and jet ventilation [24].
• Significant differences were found between the 33 infants born after 24 hours of betamethasone and those delivered before in terms of survival 90.1% v 56.6% (P = .001), respiratory distress syndrome 27.2% v 73.6% (P = .0001), and need for intermittent positive pressure ventilation 42.4% v 81.1% (P = .0005) [10].
• The observed changes in LV function with enflurane are largely independent of cardiac rate, adrenergic and cholinergic influences, and the hemodynamic consequences of intermittent positive-pressure ventilation [25].
• METHODS: The haemodynamic effects of isoflurane or halothane anaesthesia during spontaneous or IPPV were studied non-invasively in 32 laterally recumbent horses undergoing elective surgery [21].

Gene context of Intermittent Positive-Pressure Ventilation

• Domiciliary nocturnal nasal intermittent positive pressure ventilation in COPD: mechanisms underlying changes in arterial blood gas tensions [22].
• Our results suggest that in patients with normal systemic hemodynamics, the effects of HFJV and IPPV on CBF are comparable at identical levels of mean airway pressure [26].
• They were compared to the Rint changes induced by oral intermittent positive-pressure ventilation (oIPPV) in the same individuals [27].
• STUDY OBJECTIVES: Noninvasive intermittent positive-pressure ventilation (NIPPV) may improve exercise performance in COPD patients [28].
• Each dog had 5 ml of mucin injected 10 cm down the endotracheal tube prior to a 30-sec period of intermittent positive pressure ventilation [29].

Analytical, diagnostic and therapeutic context of Intermittent Positive-Pressure Ventilation

• Arterial to end-tidal CO2 tension gradients were measured in 18 dogs during spontaneous breathing (SB), intermittent positive-pressure ventilation (IPPV), and both low-frequency and high-frequency jet ventilation (LFJV and HFJV) [24].
• Total parenteral nutrition (TPN) increases CO2 production (VCO2) in patients on intermittent positive-pressure ventilation who cannot match their CO2 excretion to the CO2 load, leading to an increase in PaCO2 [30].
• She was treated on an intensive care unit with intermittent positive pressure ventilation and general supportive measures, pulsed hyperbaric oxygen therapy and recombinant human erythropoietin [31].
• Fifty children undergoing tonsillectomy were anaesthetized using either a spontaneous ventilation (SV) technique with halothane (and nitrous oxide in oxygen) or intermittent positive pressure ventilation (IPPV) (with nitrous oxide, in oxygen) facilitated by atracurium 0.5 mg kg-1 [32].
• The effect on central haemodynamics of a stepwise increase in airways pressure from spontaneous breathing (SB) to intermittent positive pressure ventilation with a positive end-expiratory pressure (PEEP) of 0, 8, 16 and 24 cmH2O was studied in eight pigs under ketamine anaesthesia [33].

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