title: Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial.
abstract: 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.
authors.affiliation: Department of Pulmonary Rehabilitation, University of Modena, and Ospedale Villa Pineta, Via Gaiato 127, Pavullo, Italy. clini.enrico@unimore.it
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Clini
authors.forename: Francesca Degli
authors.initials: FD
authors.lastname: Antoni
authors.forename: Michele
authors.initials: M
authors.lastname: Vitacca
authors.forename: Ernesto
authors.initials: E
authors.lastname: Crisafulli
authors.forename: Mara
authors.initials: M
authors.lastname: Paneroni
authors.forename: Sheila
authors.initials: S
authors.lastname: Chezzi-Silva
authors.forename: Maurizio
authors.initials: M
authors.lastname: Moretti
authors.forename: Ludovico
authors.initials: L
authors.lastname: Trianni
authors.forename: Leonardo M
authors.initials: LM
authors.lastname: Fabbri
mesh_terms: 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