A Comparison of Intrapulmonary Percussive Ventilation and conventional Chest Physical Therapy for COPD patients hospitalized for acute exacerbation

Abstract

Hypothesis: COPD patients hospitalized with acute exacerbation are often referred to physical therapy for mobilization of secretions. Physiotherapy using Intrapulmonary Percussive Ventilation (IPV) employs a device causing airways to vibrate, -thus improving mucus clearance. We hypothesized that IPV will achieve better clinical results compared to conventional Chest Physical Therapy (CPT). Method: Single blind Randomized Controlled Trial conducted at our Medical Center. COPD severity was assessed by the COPD Assessment Test and spirometry; subjects received usual medical care for acute COPD exacerbation protocol and were randomized to three physical therapy intervention treatments (IPV or CPT) during 24 hours, starting as close to admission as possible. Outcome measures were hospital length of stay, sputum volume and Arterial Blood Gases. Results: 18 COPD patients with FEV1 34.2+/-11.9 %predicted were recruited and randomized to IPV (n=10) and CPT (n=8). Average+/-SD length of hospital stay did not differ between the groups (IPV: 2.8+/-2.3 days; CPT: 2.9+-1.7 days [p=0.901]). The sputum volume and weight accumulated during the treatments also showed no significant difference (p=0.364). Only the IPV group showed a significant improvement in discharge PCO2 & pH levels compared to admission (PCO2 from 63.73 to 54.94 [p=0.0366]; PH from 7.3084 to 7.3804 [p=0.0163]). Conclusions: In this small pilot study, the comparison between IPV and CPT for AECOPD patients showed no advantage regarding hospital length of stay or sputum volume. The IPV group showed a clinically significant improvement in PCO2 & pH levels at discharge.