COMPARISON OF INTRAPULMONARY PERCUSSIVE VENTILATION AND CHEST PHYSIOTHERAPY - A PILOT-STUDY IN PATIENTS WITH CYSTIC-FIBROSIS

Study objective: To compare the intrapulmonary percussive ventilator ( IPV) to chest physiotherapy (P&PD) with respect to acute changes in (1 ) pulmonary function and (2) sputum physical properties in patients wi th cystic fibrosis (CF).Design: Randomized crossover. Setting: Communi ty-based CF referral center. Participants: Nine nonhospitalized person s (range, 7 to 40 years; median, 12.4 years) with moderate to excellen t Shwachman scores. Interventions: Three treatment regimens: (1) 2.5 m g albuterol delivered via IPV (internal percussive component activated ); (2) 2.5 mg .albuterol delivered via IPV (internal percussive compon ent inactivated), followed by P&PD; and (3) 2.5 mg albuterol delivered via updraft nebulizer, followed by P&PD. Measurements and results: Ou tcome measures included pulmonary function testing (PFTs) and quantita tive and qualitative sputum analysis. Among the three treatment groups , there were no significant differences in the change in predicted PFT s 1 h or 4 h after treatment, nor in the volume of sputum expectorated in the first 4 or in the subsequent 20 h. Among patients receiving IP V, more serious disease was associated with greater improvement in FEF 25-75 1 h after treatment, but these differences disappeared by 4 h. T here were no meaningful differences in viscoelastic characteristics of sputum expectorated after each treatments. Participants reported gene ral satisfaction with no adverse effects while using IPV. Conclusions: This initial pilot study suggests (1) stable patients with CF tolerat ed one treatment of IPV without adverse sequelae, and (2) IPV was as e ffective as standard aerosol and P&PD in improving short-term PFT resu lts and enhancing sputum expectoration.