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Comparison of Intrapulmonary Percussive Ventilation and High Frequency Chest Wall Oscillation in Patients With Severe Chronic Obstructive Pulmonary Disease
October 2014, Vol 146, No. 4_MeetingAbstracts
Pulmonary Rehabilitation | October 2014
Comparison of Intrapulmonary Percussive Ventilation and High Frequency Chest Wall Oscillation in Patients With Severe Chronic Obstructive Pulmonary Disease Antonello Nicolini, MD; Davide Russo, RT; Bruna Grecchi, RT Respiratory Diseases Unit, Sestri Levante, Italy
Chest. 2014;146(4_MeetingAbstracts):802A. doi:10.1378/chest.1962565
Abstract SESSION TITLE: Physiology/PFTs/Rehabilitation Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM PURPOSE: Respiratory physiotherapy is an important tool in the treatment of chronic obstructive pulmonary disease (COPD). Intrapulmonary percussive ventilation (IPV) and high frequency chest wall oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We test the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over PT in patients with severe COPD ( FEV1 < 50%).
METHODS: Sixty patients were randomized to three groups ( 20 patients in each group) : a group was treated with PT and IPV, a group with PT and HFCWO and a group with PT alone. Primary outcome measures included dyspnea scale (MMRC),breathlessness, cough, and sputum scales, as well as daily life activity evaluations (CAT, BCSS). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis (ABG), and hematological examinations.
RESULTS: Both patients in the IPV group and in the HFCWO group showed a significant improvement in the tests of dyspnea and quality of life assessment (MMRC, BCSS,CAT) compared to the control group, as well as in pulmonary function tests (FVC,FEV1,FEV1/FVC%,TLC,RV,DLCO,MIP,MEP) and ABG. However, in the group comparison analysis for the same variables between IPV group and HFCWO group we observed a significant improvement in the IPV group MIP, MEP (p≤0.01) and BCSS (p≤ 0.001), CAT (p≤ 0.02).
CONCLUSIONS: The two techniques improve the quality of life and lung function in patients with severe COPD. IPV demonstrated a significant greater effectiveness in improving some pulmonary function tests linked to the respiratory muscle strength and quality of life tools (BCSS,CAT) than HFCWO.
CLINICAL IMPLICATIONS: Our study suggests that IPV and HFCWO should be considered as additional therapy in patients with severe COPD DISCLOSURE: The following authors have nothing to disclose: Antonello Nicolini, Davide Russo, Bruna Grecchi No Product/Research Disclosure Information
Pulmonary Rehabilitation | October 2014
Comparison of Intrapulmonary Percussive Ventilation and High Frequency Chest Wall Oscillation in Patients With Severe Chronic Obstructive Pulmonary Disease Antonello Nicolini, MD; Davide Russo, RT; Bruna Grecchi, RT Respiratory Diseases Unit, Sestri Levante, Italy
Chest. 2014;146(4_MeetingAbstracts):802A. doi:10.1378/chest.1962565
Abstract SESSION TITLE: Physiology/PFTs/Rehabilitation Posters SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM PURPOSE: Respiratory physiotherapy is an important tool in the treatment of chronic obstructive pulmonary disease (COPD). Intrapulmonary percussive ventilation (IPV) and high frequency chest wall oscillation (HFCWO) are techniques designed to create a global percussion of the lung which removes secretions and probably clears the peripheral bronchial tree. We test the hypothesis that adding IPV or HFCWO to the best pharmacological therapy (PT) may provide additional clinical benefit over PT in patients with severe COPD ( FEV1 < 50%).
METHODS: Sixty patients were randomized to three groups ( 20 patients in each group) : a group was treated with PT and IPV, a group with PT and HFCWO and a group with PT alone. Primary outcome measures included dyspnea scale (MMRC),breathlessness, cough, and sputum scales, as well as daily life activity evaluations (CAT, BCSS). Secondary outcome measures were pulmonary function testing, arterial blood gas analysis (ABG), and hematological examinations.
RESULTS: Both patients in the IPV group and in the HFCWO group showed a significant improvement in the tests of dyspnea and quality of life assessment (MMRC, BCSS,CAT) compared to the control group, as well as in pulmonary function tests (FVC,FEV1,FEV1/FVC%,TLC,RV,DLCO,MIP,MEP) and ABG. However, in the group comparison analysis for the same variables between IPV group and HFCWO group we observed a significant improvement in the IPV group MIP, MEP (p≤0.01) and BCSS (p≤ 0.001), CAT (p≤ 0.02).
CONCLUSIONS: The two techniques improve the quality of life and lung function in patients with severe COPD. IPV demonstrated a significant greater effectiveness in improving some pulmonary function tests linked to the respiratory muscle strength and quality of life tools (BCSS,CAT) than HFCWO.
CLINICAL IMPLICATIONS: Our study suggests that IPV and HFCWO should be considered as additional therapy in patients with severe COPD DISCLOSURE: The following authors have nothing to disclose: Antonello Nicolini, Davide Russo, Bruna Grecchi No Product/Research Disclosure Information