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Respiratory Management (Acute Phase)

Intermittent Positive Pressure Breathing

Intermittent positive pressure breathing (IPPB) is a respiratory therapy that is used to expand the lungs and induce hyperinflation (Laffont et al. 2008). Little is known about the effects of IPPB in SCI patients, and very little literature is published for patients with acute SCI. The limited studies that do exist examining IPPB in patients with quadriplegia, very few complications occur after treatment (Laffont et al. 2008).

Author (Year)


Research Design

Sample Size

Methods Outcome
Stiller et al. (1992)




Population: Mean age: 34 yr; Gender: male=3, female=2; Level of injury: C5-C7; Severity of injury: not specified.

Intervention: All patients received intermittent positive pressure breathing (IPPB).

Outcome Measures: Lung volume, vital capacity, tidal volume.

Chronicity: Patients were studied beginning within 24 hr of sustaining injury.

1.     On admission, patients had significantly reduced resting vital capacity compared to normal values (p<0.001).

2.     Lung volume was significantly higher during IPPB compared to resting values (p<0.001).

3.     Immediately after receiving IPPB, vital capacity (p<0.02), but not tidal volume (p>0.05), was significantly higher compared to resting levels.


In a pre-post study by Stiller et al. (1992), the effectiveness of intermittent positive pressure breathing on lung capacity was studied. The authors found that this style of mechanical ventilation significantly increased lung volume, as well as vital capacity (Stiller et al. 1992).


There is level 4 evidence (from one pre-post study: Stiller et al. 1992) that intermittent positive pressure breathing may increase lung volume as well as vital lung capacity in acute SCI individuals.

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