Objective: To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. Design and setting: Randomized multicenter trial in two weaning centers in northern Italy. Patients and participants: 46 tracheostomized patients (age 70 ± 7 years, 28 men, arterial blood pH 7.436 ± 0.06, PaO2/FIO2 238 ± 46) weaned from mechanical ventilation. Interventions: 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). Measurements and results: Arterial blood gases, PaO2/FIO2 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 PaO2/FIO2 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. © 2006 Springer-Verlag.
Intrapulmonary percussive ventilation in tracheostomized patients: A randomized controlled trial / Clini, Enrico M.; Antoni, Francesca Degli; Vitacca, Michele; Crisafulli, Ernesto; Paneroni, Mara; Chezzi-Silva, Sheila; Moretti, Maurizio; Trianni, Ludovico; Fabbri, Leonardo M.. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 32:12(2006), pp. 1994-2001. [10.1007/s00134-006-0427-8]
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