Effect of Intrapulmonary Percussive Ventilation on Mucus Clearance in Duchenne Muscular Dystrophy Patients: A Preliminary Report
OBJECTIVE: To determine the effects of intrapulmonary percussive ventilation (IPV) on mucus clearance in tracheostomized Duchenne muscular dystrophy patients. METHODS: We studied 8 patients, 5 of whom had mucus hypersecretion (> 30 mL/d). In a randomized, cross-over study we compared
assisted mucus clearance techniques with and without IPV. There were 2 treatment sequences and each patient received 5 consecutive days of each treatment sequence, delivered 3 times a day. One sequence consisted of (1) assisted mucus clearance technique (AMCT, which involves forced expiratory
technique and manual assisted cough), (2) endotracheal suctioning, (3) nebulizer administration of 5 mL of 0.9% sodium chloride solution for 5 min, (4) a second AMCT session, (5) endotracheal suctioning, (6) 45 min after the end of the nebulizer treatment a third AMCT session, (7) endotracheal
suctioning. The other treatment sequence was the same except that it included IPV during the 5-min nebulizer treatment. The collected secretions were weighed. Vital capacity was measured once, before the treatments. Heart rate, respiratory rate, oxyhemoglobin saturation, end-tidal carbon dioxide,
airway resistance, and peak expiratory flow were measured before and at 45 min after the treatments. Mean values were compared using analysis of variance with repeated measures. RESULTS: In patients with hypersecretion the mean SD weight of the collected secretions was significantly higher
with IPV (6.53 ± 4.77 g vs 4.57 ± 3.50 g, p = 0.01). Heart rate, respiratory rate, oxyhemoglobin saturation, end-tidal carbon dioxide, airway resistance, and peak expiratory flow did not differ statistically between the 2 treatments. CONCLUSIONS: IPV is a safe airway clearance
method for tracheostomized Duchenne muscular dystrophy patients, and this preliminary study suggests that IPV increases the effectiveness of assisted mucus clearance techniques.
DUCHENNE MUSCULAR DYSTROPHY;
INTRAPULMONARY PERCUSSIVE VENTILATION;
Document Type: Research Article
Subacute Respiratory Rehabilitation Unit, Mechanical Ventilation Centre and Neuromuscular Excellency Centre, Vrije Universiteit Brussel-Ziekenhuis De Bijtjes, Brussels, Belgium, Ziekenhuis De Bijtjes, Inkendaalstraat 1, B-1602 Vlezenbeek,
Belgium;, Email: firstname.lastname@example.org
Subacute Respiratory Rehabilitation Unit, Mechanical Ventilation Centre and Neuromuscular Excellency Centre, Vrije Universiteit Brussel-Ziekenhuis De Bijtjes, Brussels, Belgium
Publication date: October 1, 2003
More about this publication?