title: Safety and efficacy of short-term intrapulmonary percussive ventilation in patients with bronchiectasis.
abstract: BACKGROUND
  Treatment of bronchiectasis includes drugs, oxygen therapy, and bronchial-clearance maneuvers.
  
  
  OBJECTIVE
  To assess the safety and efficacy of intrapulmonary percussive ventilation (IPV) compared to traditional standard chest physical therapy in patients with bronchiectasis and productive cough.
  
  
  METHODS
  In a randomized crossover study, 22 patients underwent, on consecutive days, IPV and chest physical therapy. Before each treatment session, immediately after the session, 30 min after the session, and 4 hours after the session we measured S(pO(2)), heart rate, respiratory rate, and (with a visual analog scale) the patient's subjective sensation of phlegm encumbrance and dyspnea. Immediately after each treatment session we also measured (via visual analog scale) the patient's discomfort. We also measured the volume and wet and dry weight of collected sputum.
  
  
  RESULTS
  No adverse effects were so severe as to require discontinuation of treatment, and the incidence of adverse effects was similar in the groups (27%). Heart rate (P = .002) and respiratory rate (P = .047) decreased during treatment, and sensation of phlegm encumbrance improved (P = .03) with both treatments. Only IPV improved (P = .004) the sensation of dyspnea. The patients found IPV more comfortable than our traditional standard chest physical therapy (P = .03). Both treatments caused important phlegm production, but there were no differences in sputum volume, wet weight, or dry weight.
  
  
  CONCLUSIONS
  In patients with bronchiectasis and productive cough, short-term IPV was as safe and effective as traditional chest physical therapy, with less discomfort.
authors.affiliation: Servizio di Riabilitazione Cardio-Respiratoria, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Lumezzane, Lumezzane, Italy. mara.paneroni@fsm.it
authors.forename: Mara
authors.initials: M
authors.lastname: Paneroni
authors.forename: Enrico
authors.initials: E
authors.lastname: Clini
authors.forename: Carla
authors.initials: C
authors.lastname: Simonelli
authors.forename: Luca
authors.initials: L
authors.lastname: Bianchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Degli Antoni
authors.forename: Michele
authors.initials: M
authors.lastname: Vitacca
mesh_terms: D001987:Bronchiectasis / Q000628:therapy*; D018592:Cross-Over Studies; D004417:Dyspnea / Q000628:therapy; D005260:Female; D006339:Heart Rate; D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D056152:Respiratory Rate; D012138:Respiratory Therapy; D013183:Sputum