Benefit of in-phase chest wall vibration on the pulmonary hemodynamics in patients with chronic obstructive pulmonary disease.
OBJECTIVE
Chest wall vibration of contracting intercostal muscles (in-phase vibration, (IPV)) improves O2 saturation in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the effect of IPV on the pulmonary hemodynamics in patients with COPD.


METHODS
Twelve patients with COPD (FEV1%, 43.7 +/- 14.4%) underwent pulmonary artery catheterization in the supine position; hemodynamic variables as well as arterial and mixed venous gas tension were measured at baseline and after 15 min of IPV with IPV continued during the measurement.


RESULTS
Mean pulmonary arterial pressure (Ppa, 21.3 +/- 5.0-19.1 +/- 4.8 mmHg and pulmonary vascular resistance (PVR, 294.6 +/- 196.0-228.5 +/- 101.7 dyne.sec.cm-5) decreased significantly, but there was no change in heart rate, cardiac index or systemic blood pressure. PaO2 increased (66.5 +/- 10.3-70.0 +/- 9.7 Torr) and PaCO2 decreased (46.6 +/- 8.9-45.0 +/- 10.1 Torr) significantly. Minute ventilation and tidal volume increased significantly in five out of the eight patients in whom ventilation was monitored throughout the study.


CONCLUSIONS
IPV improves gas exchange and pulmonary circulation without affecting systemic circulation.
Nakayama
H
H
Second Department of Physiology, Showa University School of Medicine, Tokyo, Japan.
Shibuya
M
M
Kaneko
N
N
Yamada
M
M
Suzuki
H
H
Arakawa
M
M
Homma
I
I
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002407:Catheterization, Swan-Ganz; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007366:Intercostal Muscles / Q000503:physiopathology; D008168:Lung / Q000098:blood supply / Q000503:physiopathology*; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D008297:Male; D008451:Maximal Voluntary Ventilation / Q000502:physiology; D008875:Middle Aged; D009119:Muscle Contraction; D010100:Oxygen / Q000097:blood; D011652:Pulmonary Circulation / Q000502:physiology; D011659:Pulmonary Gas Exchange / Q000502:physiology; D016683:Supine Position; D013990:Tidal Volume / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology; D014732:Vibration / Q000627:therapeutic use*
D010100:Oxygen