Document Detail


Effect of intrapulmonary percussive ventilation on expiratory flow limitation in chronic obstructive pulmonary disease patients.
MedLine Citation:
PMID:  19327288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aims of this prospective study were (1) to select, after weaning and extubation, chronic obstructive pulmonary disease (COPD) patients with expiratory flow limitation (EFL) measured by the negative expiratory pressure method and (2) to assess, in these patients, the short-term (30 minutes) physiologic effect of a session of intrapulmonary percussive ventilation (IPV). MATERIALS AND METHODS: All COPD patients who were intubated and needed weaning from mechanical ventilation were screened after extubation. The patients were placed in half-sitting position and breathed spontaneously. The EFL and the airway occlusion pressure after 0.1 second (P0.1) were measured at the first hour after extubation. In COPD patients with EFL, an IPV session of 30 minutes was promptly performed by a physiotherapist accustomed to the technique. Expiratory flow limitation, gas exchange, and P0.1 were recorded at the end of the IPV session. RESULTS: Among 35 patients studied after extubation, 25 patients presented an EFL and were included in the study. Intrapulmonary percussive ventilation led to a significant improvement in EFL, respectively, before and 30 minutes after IPV (65.4 +/- 18.2 vs 35.6 +/- 22.8; P < .05). Three patients were not expiratory flow limited after IPV. Intrapulmonary percussive ventilation led to a significant decrease in P0.1 (3.9 +/- 1.6 vs 2.8 +/- 1.1; P < .05). Thirty minutes of IPV led to a significant increase in Pao(2) and pH and a decrease in Paco(2) and respiratory rate (P < .05). CONCLUSION: In COPD patients, a session of IPV allowed a significant reduction of EFL and of P01 and a significant improvement of gas exchange.
Authors:
Frédéric Vargas; Alexandre Boyer; Hoang Nam Bui; Hervé Guenard; Didier Gruson; Gilles Hilbert
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-05-14
Journal Detail:
Title:  Journal of critical care     Volume:  24     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-08     Completed Date:  2009-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-9     Citation Subset:  IM    
Affiliation:
Département de Réanimation Médicale, Hôpital Pellegrin Tripode, 33076 Bordeaux Cedex, France. frederic.vargas@chu-bordeaux.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
High-Frequency Ventilation*
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive / physiopathology*,  therapy*
Respiratory Function Tests
Respiratory Mechanics

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