TITLE: Prospective randomised controlled study of use of intrapulmonary percussive ventilation with chest physiotherapy after cardiac surgery

  ABSTRACT:


BODY.INTRODUCTION:
Intrapulmonary Percussive Ventilation® (IPV) is a complementary chest physiotherapy technique for restrictive and obstructive disease treatment. We tested its tolerance and efficacy after cardiac surgery in a prospective randomised controlled study.

BODY.PATIENTS AND METHODS:
Forty patients receiving chest physiotherapy during their first 3 days after cardiac surgery were randomised in two groups: the control group benefited from one conventional chest physiotherapy per day, and the IPV group received same treatment alternated with IPV1® application each day. Treatment duration was the same. Blood gas, flow-volume curve, subjective sensation of dyspnoea (using visual scale), thorax radiograph, postoperative complications and hospital length of stay were analysed.

BODY.RESULTS:
(Table 1) Both groups were comparable regardless of type of intervention, comorbidities and demography. Blood gas analysis (days 1 and 3) and frequency of postoperative clinical complications were not statistically different. However, fewer atelectasis were seen in the IPV group on thorax radiograph. Subjective dyspnoea sensation is less in the patients of the IPV group. Hospital length of stay (LOS) was longer in the control group. No IPV treatment was stopped for intolerance.   Table 1 IPV group ( n  = 20) Control group ( n  = 20) P  value Atelectasis 0 5 0.048 ICU LOS (days) 3.5 ± 0.82 4.6 ± 4.28 0.98 Hospital LOS (days) 10.4 ± 0.99 13 ± 4.93 0.009 

BODY.CONCLUSION:
Tolerance to IPV treatment was good early after cardiac surgery. In this study, use of IPV during the first three postoperative days reduces hospital LOS after cardiac surgery. However, a larger study is necessary to confirm these results.

Question: Compared to Control what was the result of Intrapulmonary percussive ventilation on Atelectasis ?
Evidence: Blood gas analysis (days 1 and 3) and frequency of postoperative clinical complications were not statistically different.
Answer: significantly decreased