Pulmonary Vest Therapy in Pediatric Long-Term Care

Abstract

VT resulted in more effective suctioning of pulmonary secretions, reduced incidence of pneumonia, and reduced number of hospitalizations for pneumonia. In patients with epilepsy, VT resulted in reduced seizure frequency. VT was tolerated well, without complications or side effects. Further clinical investigations of the use of VT in cerebral palsy are indicated.

Interventions for management of respiratory disease in young people with cerebral palsy: A systematic review

“…Figure shows that 3,347 unique records were identified, from which 233 full texts were assessed for eligibility, and 37 records retained. Three studies were reported in two papers each (Plioplys, Ebel, & Kasnicka, ; Plioplys, Lewis, & Kasnicka, ), (Adams, ; Adams et al, ), (Sullivan et al, ; Sullivan et al, ), so each pair was merged, giving a total of 34 studies in the systematic review.…”

“…The study designs were classified using the AACPDM rating systems shown in Table . There were three Level II studies (Lee et al, ; Siriwat et al, ; Yuan et al, ), two Level III studies (Hutzler et al, ; Shin & Kim, ), 25 Level IV studies (Adams, ; Adams et al, ; Bozkurt et al, ; Cheung et al, ; Faria et al, ; K. Fitzgerald et al, ; Garuti et al, ; Hartzell et al, ; Hsiao & Nixon, ; Ishimaru, ; Keskinen et al, ; Lephart & Kaplan, ; Littleton et al, ; Maher et al, ; Manrique & Sato, ; Meece et al, ; Miyazawa et al, ; Myatt & Beckenham, ; Noonan et al, ; O'Loughlin et al, ; Plioplys et al, ; Plioplys et al, ; Plioplys & Kasnicka, ; Preciado et al, ; Romero et al, ; Sullivan et al, ; Sullivan et al, ; Vijayasekaran et al, ), and four Level V studies (Cheng et al, ; Denbar, ; Kim et al, ; Worley et al, ). No studies were classified as Level I.…”

“…Twenty‐six studies compared the intervention with a baseline (usually routine care) before the intervention commenced (Adams, ; Adams et al, ; Bozkurt et al, ; Cheung et al, ; Denbar, ; Faria et al, ; K. Fitzgerald et al, ; Garuti et al, ; Hsiao & Nixon, ; Ishimaru, ; Keskinen et al, ; Kim et al, ; Maher et al, ; Manrique & Sato, ; Meece et al, ; Myatt & Beckenham, ; Noonan et al, ; O'Loughlin et al, ; Plioplys et al, ; Plioplys et al, ; Plioplys & Kasnicka, ; Preciado et al, ; Romero et al, ; Sullivan et al, ; Sullivan et al, ; Vijayasekaran et al, ), whereas 11 studies (including all the Level II and III studies) compared the intervention with an alternative treatment (Cheng et al, ; Hartzell et al, ; Hutzler et al, ; Lee et al, ; Lephart & Kaplan, ; Littleton et al, ; Miyazawa et al, ; Shin & Kim, ; Siriwat et al, ; Worley et al, ; Yuan et al, ).…”

“…In 23 studies, some or all participants had a history of respiratory infections (Adams, ; Adams et al, ; Bozkurt et al, ; Cheung et al, ; Faria et al, ; K. Fitzgerald et al, ; Garuti et al, ; Ishimaru, ; Keskinen et al, ; Kim et al, ; Littleton et al, ; Maher et al, ; Manrique & Sato, ; Meece et al, ; Miyazawa et al, ; Noonan et al, ; O'Loughlin et al, ; Plioplys et al, ; Plioplys et al, ; Plioplys & Kasnicka, ; Romero et al, ; Siriwat et al, ; Sullivan et al, ; Sullivan et al, ; Vijayasekaran et al, ; Yuan et al, ). The interventions in these studies were airway clearance techniques (K. Fitzgerald et al, ; Garuti et al, ; Maher et al, ; Plioplys et al, ; Plioplys et al, ; Siriwat et al, ; Yuan et al, ), positioning (Littleton et al, ), mealtime management (Adams, ; Adams et al, ; Romero et al, ), salivary gland BoNT‐A (Faria et al, ; Kim et al, ; Meece et al, ), salivary gland surgery (Manrique & Sato, ; Noonan et al, ; Vijayasekaran et al, ), antibiotics (Plioplys & Kasnicka, ), gastro‐intestinal interventions (Bozkurt et al, ; Cheung et al, ; Ishimaru, ; Miyazawa et al, ; O'Loughlin et al, ; Sullivan et al, ; Sullivan et al, ), or spinal surgery (Keskinen et al, ). Seven studies included participants with upper airway obstruction ( Cheng et al, ; Myatt & Beckenham, ; Preciado et al, ; Worley et al, ) or obstructive sleep apnoea (Denbar, ; Hartzell et al, ; Hsiao & Nixon, …”

Airway clearance in children with neuromuscular weakness

“…In contrast, use of this modality has not been well studied in patients with NMD. In seven patients with quadriplegic cerebral palsy, routine use of HFCWO therapy resulted in a reduction in the number of pneumonias and respiratory-related hospitalizations in the year after introduction of the therapy compared with the year before [34]. The authors also reported improved effectiveness of suctioning with HFCWO use in those patients with tracheostomies.…”