A comparison of intrapulmonary percussive ventilation and conventional chest physiotherapy for the treatment of atelectasis in the pediatric patient.

摘要: OBJECTIVE: Compare intrapulmonary percussive ventilation (IPV) to conventional chest physiotherapy (CPT) and determine their effects on improving atelectasis static compliance in pediatric patients. METHODS: We conducted a retrospective study of 46 patients who received IPV therapy with the Percussionator IPV-1 ventilator at frequencies 180-220 cycles/min pressures 15-30 cm H 2 O. Medicated aerosol albuterol 2.5 mg 6 mL normal saline solution was delivered each treatment. Baseline subsequent radiographs were evaluated by radiologist. used an ordinal scoring system measure degree evaluate (4 = complete collapse, 0 resolution). Then we prospective, randomized, controlled intubated mechanically ventilated compare changes compliance. daily using same as pilot evaluation. Patients volume-controlled, synchronized intermittent mandatory mode, tidal volumes 6-10 mL/kg. randomized CPT (clapping vibration) or O (equal peak ventilator), via medicated aerosol. Both treatments given every 4 h lasted 10-15 min. Static measurements calculated from exhaled plateau pressures. RESULTS: In median age receiving 4.2 years duration 6.2 days. A change score 3 1 (p < 0.001) seen. trial 3.1 years. Atelectasis scores before treatment comparable between groups (median 2.0 for both groups, p 0.530). after unchanged group 2.0, 0.421) but improved 1.0, 0.026). Treatment average days 2.1 0.018). Neither showed any following CONCLUSIONS: clinically important improvement seen therapy. controlled, clinical more than group. is safe effective method alternative airway clearance can be artificial airways.