Intrapulmonary Percussive Ventilation vs Incentive Spirometry for Children With Neuromuscular Disease

Reardon, Christine Campbell; Christiansen, Demian; Barnett, Elizabeth D.; Cabral, Howard

doi:10.1001/archpedi.159.6.526

Cited by 67 publications

(56 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antibiotic use was significantly higher with incentive spirometry (24/1,000 patient-days) compared with percussive ventilation (0/1,000 patient-days). The incentive spirometry group spent more days hospitalized (4.4/1,000 patientdays versus 0/1,000 patient-days) than the percussive ventilation group and had no episodes of pneumonia or bacterial bronchitis compared with three events in the incentive spirometry group, supporting the hypothesis that percussive ventilation may have benefits in helping to clear secretions (Reardon et al 2005).…”

Section: Volumetric Diffusive Respiratormentioning

confidence: 57%

Mechanical Ventilation

Arnal¹,

Bancalari²,

Clement³

et al. 2014

Pediatric and Neonatal Mechanical Ventilation

View full text Add to dashboard Cite

Section: Volumetric Diffusive Respiratormentioning

confidence: 57%

Mechanical Ventilation

Arnal¹,

Bancalari²,

Clement³

et al. 2014

Pediatric and Neonatal Mechanical Ventilation

View full text Add to dashboard Cite

“…There are some RCTs involving IPV and high-frequency chest wall compression (HFCWC), but the sample sizes were small, and evidence to support or reject their use in this population is not sufficient. [28][29][30] Recommendations Supported by Low-Level Evidence 1. Cough assist techniques should be used in patients with NMD, particularly when peak cough flow is Ͻ 270 L/ min.…”

Section: Adult and Pediatric Patients With Neuromuscularmentioning

confidence: 99%

AARC Clinical Practice Guideline: Effectiveness of Nonpharmacologic Airway Clearance Therapies in Hospitalized Patients

et al. 2013

View full text Add to dashboard Cite

Airway clearance therapy (ACT) is used in a variety of settings for a variety of ailments. These guidelines were developed from a systematic review with the purpose of determining whether the use of nonpharmacologic ACT improves oxygenation, reduces length of time on the ventilator, reduces stay in the ICU, resolves atelectasis/consolidation, and/or improves respiratory mechanics, versus usual care in 3 populations. For hospitalized, adult and pediatric patients without cystic fibrosis, 1) chest physiotherapy (CPT) is not recommended for the routine treatment of uncomplicated pneumonia; 2) ACT is not recommended for routine use in patients with COPD; 3) ACT may be considered in patients with COPD with symptomatic secretion retention, guided by patient preference, toleration, and effectiveness of therapy; 4) ACT is not recommended if the patient is able to mobilize secretions with cough, but instruction in effective cough technique may be useful. For adult and pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough, 1) cough assist techniques should be used in patients with neuromuscular disease, particularly when peak cough flow is < 270 L/min; CPT, positive expiratory pressure, intrapulmonary percussive ventilation, and high-frequency chest wall compression cannot be recommended, due to insufficient evidence. For postoperative adult and pediatric patients, 1) incentive spirometry is not recommended for routine, prophylactic use in postoperative patients, 2) early mobility and ambulation is recommended to reduce postoperative complications and promote airway clearance, 3) ACT is not recommended for routine postoperative care. The lack of available high-level evidence related to ACT should prompt the design and completion of properly designed studies to determine the appropriate role for these therapies.

show abstract

“…The duration of the wash-in period reflected the suggestion that clinical benefits from HFCWC become more apparent after 6 months of treatment. 19 The data from the wash-in period were excluded from analysis. An equivalent 6-month period before treatment was also excluded from data analysis, so that no seasonal difference skewed the data.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

“…19 Other chest physical therapy modalities include end-expiratory positive pressure devices, manual chest physical therapy, and high-frequency chest wall compression (HFCWC). The selection of chest physical therapy methods used in this group of patients depends on several factors, including the cognitive status of the patient, severity of respiratory compromise, and in many ways on the clinical experience of the clinicians.…”

Section: Introductionmentioning

confidence: 99%

High-Frequency Chest Wall Compression Therapy in Neurologically Impaired Children

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Children with neurological impairment often suffer from insufficient airway secretion clearance, which substantially increases their respiratory morbidity. The goal of the study was to assess the clinical feasibility of high-frequency chest wall compression (HFCWC) therapy in neurologically impaired children with respiratory symptoms. METHODS: This was a single-center, investigator initiated, prospective study. Twenty-two subjects were studied for 12 months before and 12 months after initiation of HFCWC therapy, and 15 subjects were followed for an additional 12 months. The threshold of adherence to HFCWC therapy was 70%. The number of pulmonary exacerbations that required hospitalization was recorded. RESULTS: Forty-five percent of the subjects required hospital admission before initiation of HFCWC therapy. This rate decreased to 36% after the first year with HFCWC, and to 13% after the second year with HFCWC. There was a statistically significant reduction of the number of hospital days at follow-up, relative to before treatment. Use of an assisted-cough device or the presence of tracheostomy did not significantly affect hospitalization days. CONCLUSIONS: Regular HFCWC therapy may reduce the number of hospitalizations in neurologically impaired children.

show abstract

Intrapulmonary Percussive Ventilation vs Incentive Spirometry for Children With Neuromuscular Disease

Abstract: Intrapulmonary percussive ventilation as part of a preventive pulmonary regimen reduced days of antibiotic use and hospitalization for respiratory illness in adolescents with neuromuscular disease.

Cited by 67 publications

References 15 publications

Mechanical Ventilation

Mechanical Ventilation

AARC Clinical Practice Guideline: Effectiveness of Nonpharmacologic Airway Clearance Therapies in Hospitalized Patients

High-Frequency Chest Wall Compression Therapy in Neurologically Impaired Children

Contact Info

Product

Resources

About