Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial.
OBJECTIVE
To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients.


METHODS
Randomized multicenter trial in two weaning centers in northern Italy.


METHODS
46 tracheostomized patients (age 70 +/- 7 years, 28 men, arterial blood pH 7.436 +/- 0.06, PaO(2)/FIO(2) 238 +/- 46) weaned from mechanical ventilation.


METHODS
Patients were assigned to two treatment groups performing chest physiotherapy (control), or percussive ventilation (IMP2 Breas, Sweden) 10 min twice/day in addition to chest physiotherapy (intervention).


RESULTS
Arterial blood gases, PaO(2)/FIO(2) ratio, and maximal expiratory pressure were assessed every 5th day for 15 day. Treatment complications that showed up in 1 month of follow-up were recorded. At 15 days the intervention group had a significantly better PaO(2)/FIO(2) ratio and higher maximal expiratory pressure; after follow-up this group also had a lower incidence of pneumonia.


CONCLUSIONS
The addition of percussive ventilation to the usual chest physiotherapy regimen in tracheostomized patients improves gas exchange and expiratory muscle performance and reduces the incidence of pneumonia.
Clini
Enrico M
EM
Department of Pulmonary Rehabilitation, University of Modena, and Ospedale Villa Pineta, Via Gaiato 127, Pavullo, Italy. clini.enrico@unimore.it
Antoni
Francesca Degli
FD
Vitacca
Michele
M
Crisafulli
Ernesto
E
Paneroni
Mara
M
Chezzi-Silva
Sheila
S
Moretti
Maurizio
M
Trianni
Ludovico
L
Fabbri
Leonardo M
LM
D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial / Q000379:methods*; D014139:Tracheostomy; D015300:Ventilator Weaning