The assessment of intrapulmonary percussive ventilation (IPV) using functional imaging, forced oscillation and classical outcome parameters

K. M. H. Ides, W. Vos, L. De Backer, R. Claes, E. Oostveen, D. Vissers, W. De Backer (Merksem, Edegem, Wilrijk, Belgium)

Rationale: The regional effects of physiotherapeutic mucociliary clearance techniques are usually assessed by lung function tests. Recent advances in CT imaging modalities make it possible to assess mucociliary clearance using functional imaging.

Study objectives: Analysis of airway volume and resistance changes in COPD patients induced by intrapulmonary percussive ventilation.

Methods: 6 COPD patients have been analysed before and after IPV (2 sessions of 10 minutes with a 5 minute resting period in between). Lung function tests, FOT measurements and low dose CT scans have been taken before and after treatment.

Results: although 4 out of 5 patients coughed up at least 2 flumes, lung function tests showed no changes. Diffusion corrected for alveolar volume and Maximal Expiratory Pressure (MEP) changed but were not significant. FOT results on low frequencies gave no significant changes. CT images clearly show a shift of the intrabronchial mucus, causing regional (un)blocking of the bronchi.

Conclusion: A short term treatment with IPV has effects that are not picked up by lung function tests but can be visualized using functional imaging.

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