How to use IPPV during veterinary surgery

Intermittent positive-pressure ventilation (IPPV) is the process of manually or mechanically (via a ventilator) ventilating a patient with the use of an endotracheal or tracheostomy tube, and an anaesthetic breathing system. A patient may have difficulty with spontaneous respiration when under anaesthesia due to medication or disease, during thoracotomy or when intra-thoracic pressure is compromised due to a rupture in the thoracic cavity or diaphragm.

Manual IPPV is an inexpensive and effective method of providing regulated ventilation to an anaesthetised patient, both if the patient is unable to spontaneously ventilate, or is having difficulty ventilating sufficiently. Indications for performing IPPV include:

Causes of apnoea or hypoventilation include (Hammond, 2007):

Although IPPV appears to be a simple method of ventilation, it has many complex effects on the body. The patient should be closely monitored throughout, particularly with the combined use of capnography and pulse oximetry monitors, to ensure the ventilation provided is appropriate and sufficient.