RESPIRATORY THERAPY

also called inhalation therapy medical specialty primarily concerned with administering oxygen or other substances and providing assistance in order to maintain the breathing capacity of individuals with impaired lung function. One of the conditions frequently dealt with is obstruction of breathing passages, in which therapy may consist of clearing the airway of mucus or liquid secretion by suction. Aerosol mists of water or medication may provide easier breathing and sometimes cure in some obstructive conditions. Postural drainage is a technique in which the forces of gravity are used to promote drainage in obstruction. Aerosol and humidity treatments are used to relieve bronchospasm and mucous membrane swelling, mobilize secretions for easy removal, and administer antibiotics directly to the lungs. Water is a major therapeutic agent in bronchopulmonary disease and may be used in the form of cold steam, hot steam (vapour), or a fog (as in an oxygen or croup tent). Aerosol humidifiers called nebulizers may be powered by compressor machinery or by a hand squeeze bulb to project medication or water spray into the airway. Ultrasonic equipment may be used to propel very fine particles directly into the lungs, as in treatment of cystic fibrosis. Therapy may also involve the use of gases, including those used for anesthesia during surgery. Oxygen may be administered to assist laboured breathing. A mixture of helium and oxygen is used to treat some diseases of obstruction, and a carbon dioxide and oxygen mixture is used to stimulate the cardiovascular brain centres, improve blood flow to the brain, overcome hypoventilation (slow, laboured breathing), prevent lung collapse, and treat hiccups. Mechanical ventilation may be accomplished with negative pressure, as in the iron lung, or with positive pressure in the form of intermittent positive-pressure ventilation of breathing treatments, which are used extensively in hospitals. In the negative form the individual's trunk and lower body are placed in an airtight chamber in which a bellows creates a partial vacuum around the chest, thus pulling air into the individual's unenclosed nose and mouth. Positive pressure machinery delivers a breathing mixture under pressure to inflate the lungs and expand the chest. The former is used to treat persons with respiratory muscle paralysis, and the latter is used to treat bronchial asthma and bronchial spasm and to promote adequate lung expansion. Procedures for the treatment of respiratory failure include insertion of airway tubes into the nose or mouth (intubation) or surgical insertion of a tube directly into the trachea (tracheostomy) to restore breathing in instances of accidental trauma that may have caused swelling or hemorrhage to the upper reaches of the respiratory tract.