Comparison of effects of an intrapulmonary percussive ventilator to standard aerosol and chest physiotherapy in treatment of cystic fibrosis

Homnick, Douglas N.; White, Fred; Castro, Carol de

doi:10.1002/ppul.1950200110

Cited by 74 publications

(85 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have found IPV safe, well tolerated, and effective in various hypersecretive diseases, 9,10,13,16,21 but to our knowledge this is the first study of IPV in patients with bronchiectasis. Tsurata et al 15 and Van Ginderdeuren et al 22 found no significant changes of heart rate after IPV in 2 different trials with obese and CF patients.…”

Section: Discussionmentioning

confidence: 91%

Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

et al. 2011

View full text Add to dashboard Cite

BACKGROUND: Treatment of bronchiectasis includes drugs, oxygen therapy, and bronchialclearance maneuvers. OBJECTIVE: To assess the safety and efficacy of intrapulmonary percussive ventilation (IPV) compared to traditional standard chest physical therapy in patients with bronchiectasis and productive cough. METHODS: In a randomized crossover study, 22 patients underwent, on consecutive days, IPV and chest physical therapy. Before each treatment session, immediately after the session, 30 min after the session, and 4 hours after the session we measured S pO 2 , heart rate, respiratory rate, and (with a visual analog scale) the patient's subjective sensation of phlegm encumbrance and dyspnea. Immediately after each treatment session we also measured (via visual analog scale) the patient's discomfort. We also measured the volume and wet and dry weight of collected sputum. RESULTS: No adverse effects were so severe as to require discontinuation of treatment, and the incidence of adverse effects was similar in the groups (27%). Heart rate (P ‫؍‬ .002) and respiratory rate (P ‫؍‬ .047) decreased during treatment, and sensation of phlegm encumbrance improved (P ‫؍‬ .03) with both treatments. Only IPV improved (P ‫؍‬ .004) the sensation of dyspnea. The patients found IPV more comfortable than our traditional standard chest physical therapy (P ‫؍‬ .03). Both treatments caused important phlegm production, but there were no differences in sputum volume, wet weight, or dry weight. CONCLUSIONS: In patients with bronchiectasis and productive cough, short-term IPV was as safe and effective as traditional chest physical therapy, with less discomfort.

show abstract

Section: Discussionmentioning

confidence: 91%

Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Interruption of the inspiratory flow allows for passive expiration. It has been shown to be as effective as "standard" chest physiotherapy [40] and to assist mucus clearance and may be an alternative for some patients [41].…”

Section: High Frequency Chest Wall Oscillation and Intrapulmonary Permentioning

confidence: 99%

Physiotherapy for airway clearance in adults

1999

View full text Add to dashboard Cite

Techniques for augmenting, when necessary, the normal mucociliary and cough clearance mechanisms of the lungs are not new, but, in more recent years, techniques have been developed which are effective, comfortable and can be used independent of an assistant in the majority of adolescents and adults.Postural drainage with chest clapping and chest shaking has, in most parts of the world, been replaced by the more effective techniques of the active cycle of breathing, autogenic drainage, R-C Cornet1, Flutter1, positive expiratory pressure mask, highfrequency chest wall oscillation and intrapulmonary percussive ventilation. Glossopharyngeal breathing is being considered again and is often a useful technique for increasing the effectiveness of cough in patients with tetraplegia or neuromuscular disorders.The evidence in support of these techniques is variable, and the literature is confusing and conflicting. There may or may not be significant differences among the techniques in the short or long term. Many of the regimens now include the forced expiratory manoeuvre of a "huff" and this has probably increased the effectiveness of airway clearance. If objective differences are small, individual preferences and cultural influences may be significant in increasing adherence to treatment and in the selection of an appropriate regimen or regimens for an individual patient.

show abstract

“…IPV may be delivered via a face mask, a mouthpiece, an endotracheal tube, or a tracheostomy. Recent reports have suggested that IPV facilitates airway clearance and improves homogeneity of ventilation in patients with cystic fibrosis, [1][2][3][4][5] in patients with neuromuscular disorders with retention of mucus, 6,7 in patients with atelectasis, 8 -10 in burned patients with inhalation injury, [11][12][13] and in patients with COPD. 14 -17 Despite potential benefits related to the use of IPV therapy, the impact of setting parameters such as the ratio of inspiratory to expiratory time, the pressure, and the frequency on the mechanical effects produced by IPV devices is totally unknown.…”

Section: Introductionmentioning

confidence: 99%

Intrapulmonary Effects of Setting Parameters in Portable Intrapulmonary Percussive Ventilation Devices

Toussaint¹,

Guillet²,

Paternotte³

et al. 2012

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Despite potential benefits of intrapulmonary percussive ventilation (IPV) in various respiratory diseases, the impact of setting parameters on the mechanical effects produced by IPV in the lungs is unknown. We hypothesized that changing the parameters on IPV would modulate these effects. This in vitro study aimed at comparing the changes in intrapulmonary effects resulting from changes in parameters in 3 portable IPV devices (IMP2, Impulsator, and Pegaso). METHODS: Parameters were set in 72 combinations of frequency (90 -250 cycles/min), inspiratory to expiratory (I/E) time ratio (from 1/2 to 3/1), and pressure (10 -60 cm H 2 O). Four resulting effects were recorded on a test lung via a pneumotachometer: the expiratory to inspiratory flow ratio (E/I flow ratio), the PEEP, the ventilation, and the percussion. Percussion was assessed by the end-slope of the pressure curve. Analysis of variance was used for data analysis. RESULTS: E/I flow ratio increased with increasing I/E time ratio (P < .001). The Pegaso produced the lowest E/I flow ratio. PEEP raised 6 cm H 2 O in both IMP2 and Impulsator, and 17 cm H 2 O in the Pegaso with increasing frequency (P < .01), pressure, and I/E time ratio (P < .001). In all devices, ventilation increased with increasing pressure and decreasing frequency (P < .001). Percussion increased with increasing frequency and decreasing I/E time ratio (P < .001), and with increasing pressure when I/E time ratio was 1/1 or less. The Pegaso provided the poorest percussion. CON-CLUSIONS: This study suggests that changing the parameters considerably modulates the mechanical effects produced by portable IPV devices in the lungs. Increasing frequency increased PEEP and percussion, but decreased ventilation. Increasing I/E time increased PEEP and E/I flow ratio, and decreased percussion. Finally, increasing pressure increased PEEP and ventilation. The Pegaso produced the highest PEEP, least percussion, and smallest change in E/I flow ratio.

show abstract

Comparison of effects of an intrapulmonary percussive ventilator to standard aerosol and chest physiotherapy in treatment of cystic fibrosis

Cited by 74 publications

References 22 publications

Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

Safety and Efficacy of Short-Term Intrapulmonary Percussive Ventilation in Patients With Bronchiectasis

Physiotherapy for airway clearance in adults

Intrapulmonary Effects of Setting Parameters in Portable Intrapulmonary Percussive Ventilation Devices

Contact Info

Product

Resources

About