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The Indiscriminate Use of IPPB

Alvan L. Barach, MD; Maurice S. Segal, MD
JAMA. 1975;231(11):1141-1142. doi:10.1001/jama.1975.03240230015011.
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THE ENORMOUS increase in the use of intermittent positive pressure breathing (IPPB) devices for the delivery of therapeutic aerosols for inpatient and outpatient hospital clinics and home use appears to be related to our pursuit of technical innovations and liberal health support measures, which in a sense, provides the "economic prescription" that most patients require for their rental or purchase. The insistence on the prescription of this technique frequently creates a feeling of false security that only by employing such expensive units for the aerosol therapy will the patient be optimally treated.

Many investigators, however, have reached the conclusion that nebulized bronchodilator aerosols administered with IPPB are no more effective than nebulized bronchodilator solutions administered simply with hand bulb nebulizers or via air pumps and oxygen delivery systems, when employed for the routine management of bronchospasm in patients with acute or chronic airway obstructive disease. Miller et al1 recently


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