title: Comparison of intermittent positive pressure breathing and temporary positive expiratory pressure in patients with severe chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Results supporting the use and the effectiveness of positive expiratory, pressure devices in chronic obstructive pulmonary disease (COPD) patients are still controversial, We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over, pharmacological therapy only in patients with severe COPD.
  
  
  METHODS
  Fourty-five patients were randomized in three groups: a group was treated; with IPPB,a group was treated with TPEP and a group with pharmacological; therapy alone (control group). Primary outcome measures included the measurement of scale or, questionnaire concerning dyspnea (MRC scale),dyspnea,cough, and, sputum (BCSS) and quality of life (COPD assessment test) (CAT). Secondary, outcome measures were respiratory function testing,arterial blood gas,analysis,and hematological examinations.
  
  
  RESULTS
  Both patients in the IPPB group and in the TPEP group showed a significant, improvement in two of three tests (MRC,CAT) compared to the control, group.However,in the group comparison analysis for, the same variables between IPPB group and TPEP group we observed a, significant improvement in the IPPB group (P≤.05 for MRC and P≤.01 for, CAT). The difference of action of the two techniques are evident in the results of, pulmonary function testing: IPPB increases FVC, FEV1, and MIP; this reflects, its capacity to increase lung volume. Also TPEP increases FVC and FEV1 (less, than IPPB), but increases MEP, while decreasing total lung capacity and, residual volume.
  
  
  CONCLUSIONS
  The two techniques (IPPB and TPEP) improves significantly dyspnea; quality of; life tools and lung function in patients with severe COPD. IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools (MRC, CAT) than TPEP.
authors: Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia. Electronic address: antonello.nicolini@fastwebnet.it.
authors: Antonello
authors: A
authors: Nicolini
authors: Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia.
authors: Elena
authors: E
authors: Mollar
authors: Departamento de Rehabilitación, ASL4 Chiavarese, Chiavari, Italia.
authors: Bruna
authors: B
authors: Grecchi
authors: Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia.
authors: Norma
authors: N
authors: Landucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000295:instrumentation; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Dyspnea and quality of life tools; Enfermedad pulmonar obstructiva crónica grave; Escalas de valoración de disnea y calidad de vida; Intermittent positive pressure breathing; Presión espiratoria positiva temporal; Respiración con presión positiva intermitente; Severe chronic obstructive pulmonary disease; Temporary positive expiratory pressure