A comparison of high frequency chest wall oscillation and intrapulmonary percussive ventilation for airway clearance in pediatric patients with tracheostomy

Abstract

This study suggests that airway clearance by IPV therapy could be more effective and beneficial in providing airway clearance in specific subsets of the medically complex pediatric population.

The effect of intrapulmonary percussive ventilation in pediatric patients: A systematic review

“…IPV could play an important role in the prevention of these pulmonary complications in this population. Both Bidiwala et al and Reardon et al showed beneficial effects in most outcome measures over specific periods of time (1 y and 7 m, respectively). Fewer hospitalizations and a reduction in the use of respiratory drugs when treated regularly with IPV compared to standard physiotherapy were key findings in both articles.…”

“…The study by Van Ginderdeuren et al was the only one with a very high score with a result of nine out of 10. Four studies scored high on the overall score with a result of 7 or 6 out of 10, two scored moderate with a score of 4 or 5, and two studies scored low with a result of 3 out of 10 . These last two studies did not compare results with another group or control period, resulting in a lower overall score, because criteria involving blinding, randomization, and comparison between groups could not be scored .…”

“…For each study, the characteristics and main results are presented in Table . Of the nine included articles, four were randomized controlled trials (RCTs), two were randomized crossover trials, one was a prospective cohort study, and three were retrospective studies, Deakins et al described an RCT as well as a retrospective study. A total of 277 participants were enrolled in the studies, with 93 subjects in the study reported in Van Ginderdeuren et al being the largest study population.…”

“…The duration of the intervention differed from one therapy session to 1 year. All studies including more than one intervention group or using a crossover design comparing IPV to other ACTs (eg, conventional CPT, AD, flutter, or HFCWO) . Only one study compared IPV and assisted autogenic drainage (AAD) to a control group not receiving respiratory physiotherapy .…”

“…Bidiwala et al conducted a retrospective study comparing 1 year of treatment with HFCWO to a consecutive year with IPV in eight tracheostomy‐dependent patients with a cognitive and developmental delay. They used CHFO to deliver percussions to the ventilation.…”