Pulmonary Vest Therapy in Pediatric Long-Term Care

Plioplys, Audrius V.; Lewis, Shelley; Kasnicka, Irene

doi:10.1016/s1525-8610(05)70548-x

Cited by 39 publications

(20 citation statements)

References 4 publications

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“…Although only applied in adults with bronchiectasis, the HFCWO improved pulmonary function and quality of life and reduced dyspnea compared to GAD with breathing techniques (63). Although unstudied in pediatric populations with bronchiectasis, it is an option if the cost is not prohibitive and has been applied in children with neurological conditions and bronchiectasis, with a reduced incidence of pneumonia over 12 months (64). Other options include intrapulmonary percussive ventilation, which provides high-frequency oscillatory ventilation to produce endotracheal percussion.…”

Section: Types Of Techniquesmentioning

confidence: 99%

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

2017

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Common symptoms of chronic suppurative lung disease or bronchiectasis in children and adolescents are chronic cough with sputum production, retention of excess secretions in dilated airways, and a history of recurrent infections. Clinical management includes the prescription of airway-clearance techniques (ACTs) to facilitate mucociliary clearance, optimize sputum expectoration, relieve symptoms, and improve well-being. A wide range of ACTs are available for selection, and these strategies may be applied in isolation or in combination. The choice of technique will depend in part on the age of the child, their clinical state, and factors which may influence treatment adherence. While the evidence base for ACTs in children and adolescent with these conditions is not robust, the current available evidence in addition to clinical expertise provides guidance for technique prescription and clinical effect. An overview of the most commonly applied ACTs, including their physiological rationale and discussion of factors influencing prescription in children and adolescents is outlined in this review.

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Section: Types Of Techniquesmentioning

confidence: 99%

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

2017

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“…One study found that 12 months of HFCWC significantly decreased the number of pneumonias in subjects with cerebral palsy; however, the sample size was only 7 subjects. 21 Yuan et al 22 found a trend toward fewer hospitalizations and less intravenous antibiotic use with HFCWC in a randomized controlled trial with 23 subjects with cerebral palsy and neuromuscular disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Based on Giarraffa et al 20 and Plioplys et al, 21 the effect size for reduction in the number of hospital days was initially estimated to be between 1.36 and 1.55 days. Since Figure. Flow chart of the study timeline.…”

Section: Discussionmentioning

confidence: 99%

“…Plioplys et al 21 studied HFCWC in children with neurological impairment and cerebral palsy and found that HFCWC dramatically increased effective suctioning, defined as suctioning attempts that retrieved sputum (summation score of effective suctioning 4,825 before treatment, versus 10,445 after treatment, P ϭ .008). It is possible that HFCWC benefits children with cerebral palsy and neurological impairment by promoting the mobilization of tracheobronchial secretions and facilitating mucociliary clearance, as it does in children with cystic fibrosis.…”

Section: Discussionmentioning

confidence: 99%

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High-Frequency Chest Wall Compression Therapy in Neurologically Impaired Children

et al. 2013

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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.

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“…[1] Cough function is paramount for expectoration; however, coughing is not practical for acute pneumonic patients with respiratory failure receiving endotracheal intubation, mechanical ventilation, and sedation. [1] These patients may therefore have a large amount of pulmonary secretions, [2–5] thereby worsening bronchial hygiene, oxyhemoglobin saturation, ventilation-perfusion match, and lung atelectasis or collapse. [1,6,7] Although pneumonia is not currently an indication for chest physical therapy, [8] acute pneumonic patients with respiratory failure receiving mechanical ventilation and sedation may have the risk to develop atelectasis or lobar collapse, thereby potentially having the indication.…”

Section: Introductionmentioning

confidence: 99%

Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

Chuang

Chou²,

Lee³

et al. 2017

Medicine

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Background:Endotracheal intubation and prolonged immobilization of patients receiving mechanical ventilation may reduce expectoration function. High-frequency chest wall oscillation (HFCWO) may ameliorate airway secretion movement; however, the instantaneous changes in patients’ cardiopulmonary responses are unknown. Moreover, HFCWO may influence ventilator settings by the vigorous oscillation. The aim of this study was to investigate these issues.Methods:Seventy-three patients (52 men) aged 71.5 ± 13.4 years who were intubated with mechanical ventilation for pneumonic respiratory failure were recruited and randomly classified into 2 groups (HFCWO group, n = 36; and control group who received conventional chest physical therapy (CCPT, n = 37). HFCWO was applied with a fixed protocol, whereas CCPT was conducted using standard protocols. Both groups received sputum suction after the procedure. Changes in ventilator settings and the subjects’ responses were measured at preset intervals and compared within groups and between groups.Results:Oscillation did not affect the ventilator settings (all P > 0.05). The mean airway pressure, breathing frequency, and rapid shallow breathing index increased, and the tidal volume and SpO2 decreased (all P < 0.05). After sputum suction, the peak airway pressure (Ppeak) and minute ventilation decreased (all P < 0.05). The HFCWO group had a lower tidal volume and SpO2 at the end of oscillation, and lower Ppeak and tidal volume after sputum suction than the CCPT group.Conclusions:HFCWO affects breathing pattern and SpO2 but not ventilator settings, whereas CCPT maintains a steadier condition. After sputum suction, HFCWO slightly improved Ppeak compared to CCPT, suggesting that the study extends the indications of HFCWO for these patients in intensive care unit. (ClinicalTrials.gov number NCT02758106, retrospectively registered.)

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Pulmonary Vest Therapy in Pediatric Long-Term Care

Cited by 39 publications

References 4 publications

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

High-Frequency Chest Wall Compression Therapy in Neurologically Impaired Children

Instantaneous responses to high-frequency chest wall oscillation in patients with acute pneumonic respiratory failure receiving mechanical ventilation

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