The aim of the study is to evaluate the effect of intrapulmonary percussive ventilation physiotherapy (IPVP) on the cardiac hemodynamics (HD), especially to determine if IPVP is safe in patients with significant left ventricular dysfunction.
IPVP was delivered with constant setting conditions by BIRD IPV2 PERCUSSIONNAIR during 30 minutes in 42 stable patients, who were under mechanical ventilation and sedation in the ICU; 22 of them had had by-pass cardiac surgery and 20 had been treated for sepsis. Blood pressures (BP), heart rate (HR) and arterial blood gas were measured at baseline (t0), at 10 minutes (t10) of IPVP and at 40 minutes (t40). Transoesophageal echocardiography (TEE) was also performed with Philips Sonos 5500, at the same times to evaluate ejection fraction (EF), left and right end-diastolic areas (LEDA and REDA), E and A Doppler wave velocities as well as the deceleration time (DT) at the mitral valve and S and D Doppler wave velocities of the left pulmonary vein. Thoraco-pulmonary compliance and FiO2 were calculated before starting IPVP. Student-t test and ANOVA test with repeated measurement were used for statistics.
At baseline, 24 patients had significant left ventricular (LV) dysfunction on TEE (57%); Thoraco-pulmonary compliance and FiO2 were not different between patients with and without LVD and between septic and post-operative patients. IPVP increased significantly PaO2 in patients with and without LVD, at t10 from the baseline (p<0.05): 140.4+/−42.7 mm Hg vs.114.8+/−38 mm Hg, and regardless of their disease. However, there was no significant variation of BP, HR and in other TEE parameters, excepted there was a trend of the increase of E wave velocity at t10.
IPVP can significantly improve oxygenation and has no harmful effect on the HD of ventilated patients, regardless of their LV function.
N. D Nguyen, None.