Intrapulmonary Percussive Ventilation as an Airway Clearance Technique in Subjects With Chronic Obstructive Airway Diseases

Reychler, Grégory; Debier, Emilie; Contal, Olivier; Audag, Nicolas

doi:10.4187/respcare.05876

Cited by 30 publications

(27 citation statements)

References 49 publications

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“…They found a reduction in the duration of hospitalisation and have observed an improvement in gas exchange only during the exacerbation phase in patients with chronic obstructive airway disease. In patients with cystic fibrosis, no difference was observed in the static and dynamic lung volume 26 . Cough is usually not impaired in patients with chronic obstructive airway disease and cystic fibrosis, thus potentially explaining the contrasting results.…”

Section: Discussionmentioning

confidence: 83%

“…The results of studies using IPV and HFCWC for other pathologies show similarities and differences as compared with our results. Reychler et al (2018) have performed a systematic review and compared IPV with other airway clearance techniques. They found a reduction in the duration of hospitalisation and have observed an improvement in gas exchange only during the exacerbation phase in patients with chronic obstructive airway disease.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review on the effects of high frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease

et al. 2021

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Background: Respiratory insufficiency is the most common cause of mortality among patients with a neuromuscular disease. Methods: We explored the effects of high frequency wall compression and intrapulmonary percussive ventilation, compared with standard care or no treatment, on the lung volume and capacity, and quality of life in patients with neuromuscular disease during respiratory infections or in stable periods. We further assessed the effects of these two interventions on clinical value, complications, and survival. The literature search was performed on Embase, MEDLINE, CINAHL, CENTRAL and PEDro. Randomised controlled trials and cross-over studies were eligible. Results: Five studies were included, and results were presented narratively. High frequency wall compression was not shown to be superior to standard care in terms of lung volume and capacity, quality of life, complications, and survival rate. Compared with standard care, intrapulmonary percussive ventilation showed non-significant differences in terms of lung volume and capacity, and the risk of respiratory infection. Standard care was nevertheless associated with a significantly higher risk of days of hospitalisation (Incidence Rate Ratio 8.5 [1.1-67]) and of antibiotic use than intrapulmonary percussive ventilation (Incidence Rate Ratio 43 [6-333]). Conclusions: Due to large variety of reported outcomes, missing data and limited number of studies, no meta-analysis could be conducted. The results should be interpreted with caution as the results have a very low certainty of evidence and reported outcomes have a high risk of bias. The evidence for high frequency wall compression and intrapulmonary percussive ventilation is still insufficient to draw final conclusions. Protocol registration: PROSPERO ID: CRD42017064703.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

A systematic review on the effects of high frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease

et al. 2021

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“…IPV is a respiratory physiotherapy technique that consists in delivery of small volumes of air into the airways, typically in the 1-10 Hz frequency and 10-50 cmH 2 O pressure ranges (Reychler et al, 2018). It is currently used to mobilize secretions, promote lung recruitment and improve gas exchange in chronic conditions such as neuromuscular diseases, cystic fibrosis, and chronic obstructive pulmonary disease.…”

Section: Discussionmentioning

confidence: 99%

Low-Frequency Intrapulmonary Percussive Ventilation Increases Aerosol Penetration in a 2-Compartment Physical Model of Fibrotic Lung Disease

Guellec

Allimonnier

Heuzé-Vourc’h

et al. 2020

Front. Bioeng. Biotechnol.

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In patients with fibrotic pulmonary disease such as idiopathic pulmonary fibrosis (IPF), inhaled aerosols deposit mostly in the less affected region of the lungs, resulting in suboptimal pharmacokinetics of airway-delivered treatments. Refinement of aerosol delivery technique requires new models to simulate the major alterations of lung physiology associated with IPF, i.e., heterogeneously reduced lung compliance and increased airway caliber. A novel physical model of the respiratory system was constructed to simulate aerosol drug delivery in spontaneously breathing (negative pressure ventilation) IPF patients. The model comprises upper (Alberta ideal throat) and lower airway (plastic tubing) models and branches into two compartments (Michigan lung models) which differ in compliance and caliber of conducting airway. The model was able to reproduce the heterogeneous, compliance-dependent reduction in ventilation and aerosol penetration (using NaF as a model aerosol) seen in fibrotic lung regions in IPF. Of note, intrapulmonary percussive ventilation induced a 2-3-fold increase in aerosol penetration in the low-compliance/high airway caliber compartment of the model, demonstrating the responsiveness of the model to therapeutic intervention.

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“…Studies have revealed that the use of HFCWO in CF may lead to a decline in lung function, oxygen desaturation and exacerbations (50)(51)(52). Current evidence also does not suggest a benefit of IPV in patients with CF (53).…”

Section: B Cystic Fibrosismentioning

confidence: 99%

Secretion management in patients with ineffective airway clearance with non-invasive mechanical ventilation use: Expert guidance for clinical practice

Hadda

Suri

Pahuja

et al. 2021

Monaldi Arch Chest Dis

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Non-invasive ventilation (NIV) is a mainstay of management of chronic respiratory failure in many disorders which are known to cause abnormal airway secretion clearance. Currently, there is no guidance regarding either the secretion handling during NIV use or the role of NIV in secretion management in these patients. The aim of this document was to provide an overview of the various techniques available in the management of respiratory secretions and their use in conjunction with NIV. Literature search was performed using the keywords, “(secretion OR secretions) AND (noninvasive ventilation OR NIV)” on PubMed and EMBASE. The search yielded 1681 and 509 titles from PubMed and EMBASE, respectively. After screening, 19 articles were included in this review. Suggestions of the expert panel were formulated by mutual consensus after reviewing the relevant literature. The draft of the expert panel’s suggestions was circulated among all authors via electronic mail for comments. Any conflicts were resolved by mutual discussion to achieve agreement. The final document was approved by all. This document by the International Network for Airway Secretions Management in NIV describes various airway secretion clearance techniques. It provides the expert panel’s suggestions for the use of these techniques in conjunction with NIV for patients with muco-obstructive and neuromuscular disorders.

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Intrapulmonary Percussive Ventilation as an Airway Clearance Technique in Subjects With Chronic Obstructive Airway Diseases

Abstract: The systematic use of IPV as an airway clearance technique in chronic obstructive airway diseases is not supported by sufficiently strong evidence to recommend routine use in this patient population.

Cited by 30 publications

References 49 publications

A systematic review on the effects of high frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease

A systematic review on the effects of high frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease

Low-Frequency Intrapulmonary Percussive Ventilation Increases Aerosol Penetration in a 2-Compartment Physical Model of Fibrotic Lung Disease

Secretion management in patients with ineffective airway clearance with non-invasive mechanical ventilation use: Expert guidance for clinical practice

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