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Critical Care |

High Frequency Percussive Ventilation, a County Medical Center Experience

Lusanik Galustanian, MD
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Kern Medical Center, Glendale, CA


Chest. 2015;148(4_MeetingAbstracts):304A. doi:10.1378/chest.2271736
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Abstract

SESSION TITLE: Mechanical Ventilation and Respiratory Failure Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To review the use of percussive ventilation in a county medical center, and to identify oxygenation parameters and their associated outcomes.

METHODS: A retrospective chart review of 26 patients which were admitted to intensive care at Kern Medical Center in Bakersfield California, who were intubated and mechanically ventilated with percussive ventilation. Survivors and non­survivors were compared according to oxygenation parameters prior to, after initiation and on study outcome.

RESULTS: All charts of intubated patients during a 3 year period at Kern Medical Center were reviewed and 26 patients were found to have undergone percussive ventilation. 13 patients (50%) survived to extubation or had an unknown outcome at Kern Medical Center, while 13 (50%) did not survive to extubation. Among survivors, there was a significant improvement in oxygenation prior to outcome with percussive ventilation (p 0.004) as opposed to non­survivors. Among the groups, Survivors had a significantly greater improvement in oxygenation from non­survivors (p 0.0004). Overall Impact of Percussive Ventilation on oxygenation ----------------Before VDR -----------After VDR--------- p Value PaO2/FiO2 147.27 +/- 112.70, 192.5 +/-131.01, 0.056 Percussive Ventilation impact on Survivors’ oxygenation -------------------Before VDR-------- After VDR ---------- p Value PaO2/FiO2 178.31 +/- 145.89, 281.38 +/- 119.05, 0.005 Percussive Ventilation impact on Non-Survivors’ oxygenation -------------------Before VDR -------After VDR-------- p Value PaO2/FiO2 116.23 +/- 55.57, 103.62 +/- 66.84, 0.636 Patient Characteristics and Length of Mechanical Ventilation --------Survivors (n=13) Non-Survivors (n=13) p Value Age (years) 41.15, 49.23, 0.101 Sex (% male) 85, 77 Days of Mechanical 10.31, 14.62, 0.348 Ventilation (days)

CONCLUSIONS: High frequency percussive ventilation improved oxygenation significantly more among survivors than non­survivors, however, no statistically significant difference was noted for improved oxygenation in non­survivors when placed on percussive ventilation, indicating that the increased oxygenation noted in the survivor group may not be a direct result of percussive ventilation alone.

CLINICAL IMPLICATIONS: High frequency percussive ventialation does not decrease lenght of mechanical ventialtion but incresaes overall oxygenation.

DISCLOSURE: The following authors have nothing to disclose: Lusanik Galustanian

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