INTERMITTENT POSITIVE-PRESSURE BREATHING: APPRAISAL OF USE IN BRONCHODILATOR THERAPY OF PULMONARY EMPHYSEMA

• Thirty-three patients with pulmonary emphysema and various degrees of bronchospasm, fibrosis, bronchiectasis, and chronic infection were treated with bronchodilator drugs, with and without intermittent positive-pressure breathing. The three bronchodilators used were power-nebulized for inhalation and were given in random sequence so as to determine which was most effective for each patient. The apparatus used for the positive-pressure breathing was set for a pressure of 15 to 20 cm. H 2 O. In the first phase of the study, each drug was used four times for each patient, twice with and twice without pressure breathing. Quantitative data on vital capacity were obtained. The improvement seen when the bronchodilators were used alone was not significantly enhanced by the pressure breathing. In later phases of the study, the treatments were given over longer periods of time, again with and without pressure breathing. Evidence of the effectiveness of the bronchodilators and the advantages of power nebulization was obtained, but the benefits did not appear to be enhanced by intermittent positive-pressure breathing.