Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Intrapulmonary percussive ventilation improves the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease using a helmet
Antonaglia V, Lucangelo U, Zin WA, Peratoner A, de Simoni L, Capitanio G, Pascotto S, Gullo A
Critical Care Medicine 2006 Dec;34(12):2940-2945
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the effect of intrapulmonary percussive ventilation (IPV) by mouthpiece during noninvasive positive-pressure ventilation with helmet in patients with exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN: Randomized clinical trial. SETTING: General intensive care unit, university hospital. PATIENTS: Forty patients with exacerbation of COPD ventilated with noninvasive positive-pressure ventilation by helmet were randomized to two different mucus clearance strategies: IPV (IPV group) versus respiratory physiotherapy (phys group). As historical control group, 40 patients receiving noninvasive positive pressure and ventilated by face mask treated with respiratory physiotherapy were studied. INTERVENTIONS: Two daily sessions of IPV (IPV group) or conventional respiratory physiotherapy (phys group). MEASUREMENTS AND MAIN RESULTS: Physiologic variables were measured at entry in the intensive care unit, before and after the first session of IPV, and at discharge from the intensive care unit. Outcome variables (need for intubation, ventilatory assistance, length of intensive care unit stay, and complications) were also measured. All physiologic variables improved after IPV. At discharge from the intensive care unit, PaCO2 was lower in the IPV group compared with the Phys and control groups (mean +/- SD 58 +/- 5.4 versus 64 +/- 5.2 mmHg, 67.4 +/- 4.2 mmHg, p < 0.01). PaO2/FiO2 was higher in IPV (274 +/- 15) than the other groups (phys 218 +/- 34; control 237 +/- 20; p < 0.01). In the IPV group, time of noninvasive ventilation (hrs) (median, 25th to 75th percentile 61, 60 to 71) and length of stay in the intensive care unit (days) (7, 6 to 8) were lower than other groups (phys 89, 82 to 96; control 87, 75 to 91; p < 0.01; and Phys 9, 8 to 9; control 10, 9 to 11; p < 0.01). CONCLUSIONS: IPV treatment was feasible for all patients. Noninvasive positive-pressure ventilation by helmet associated with IPV reduces the duration of ventilatory treatment and intensive care unit stay and improves gas exchange at discharge from intensive care unit in patients with severe exacerbation of COPD.

Full text (sometimes free) may be available at these link(s):      help