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.