Tuesday January 31, 2006
IPV - adjuvant therapy in COPD exacerbations ?
Interesting study of 33 patients, published from france last year on acute exacerbation of COPD. Inclusion and exclusion criteria were established (see reference # 1). Patients were randomly assigned to receive either standard treatment (control group) or standard treatment plus Intrapulmonary percussive ventilation (IPV group). The IPV group underwent two daily sessions of 30 minutes performed by a chest physiotherapist through a full face mask. Thirty minutes of IPV led to a significant decrease in respiratory rate, an increase in PaO2 and a decrease in PaCO2. Exacerbation worsened in 6 out of 17 patients in the control group versus 0 out of 16 in the IPV group. Therapy was tagged successful when both worsening of the exacerbation and a decrease in pH to under 7.35, which would have required non-invasive ventilation, were avoided. Also, the hospital stay was significantly shorter in the IPV group.
IPV is essentially a very effective technique to assist patients to clear retained endobronchial secretions and the resolution of diffuse patchy atelectasis. Please see full manual of IPV therapy from Dr. Bird's website here.
References / suggested readings: Click to get article/abstract
1. Intrapulmonary percussive ventilation in acute exacerbations of COPD patients with mild respiratory acidosis: a randomized controlled trial - Crit Care. 2005; 9(4): R382–R389
2. Effect of Intrapulmonary Percussive Ventilation on Mucus Clearance. in Duchenne Muscular Dystrophy Patients: A Preliminary Report - Respir Care 2003;48(10):940–947
3. A Comparison of Intrapulmonary Percussive Ventilation and Conventional Chest Physiotherapy for the Treatment of Atelectasis in the Pediatric Patient - Respir Care 2002:47(10):1162-1167
4. Airway Clearance in the ICU - rtmagazine.com - The Journal of Respiratory Care Practitioners, March 2005