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Resistance Breathing (Blow Bottles) and Sustained Hyperinflations in the Treatment of Atelectasis

Resistance breathing (blow bottles) and sustained hyperinflations employing the Elder valve were evaluated in the treatment of postoperative atelectasis. Neither maneuver evoked major improvement, yet FRC increased significantly and shunting was reduced following resistance breathing. Laboratory analyses of the pressure relationships across the lung during both maneuvers and during the Valsalva maneuver were done. A sustained deep breath, involved in all maneuvers, was necessary to achieve a maximal transpulmonary pressure gradient. Evoked responses of lung to sustained inflation are discussed in relation to alveolar opening.