Effects of intrapulmonary percussive ventilation on airway mucus clearance : A bench model

AIM: To determine the ability of intrapulmonary percussive ventilation (IPV) to promote airway clearance in spontaneously breathing patients and those on mechanical ventilation.

METHODS: An artificial lung was used to simulate a spontaneously breathing patient (Group 1), and was then connected to a mechanical ventilator to simulate a patient on mechanical ventilation (Group 2). An 8.5 mm endotracheal tube (ETT) connected to the test lung, simulated the patient airway. Artificial mucus was instilled into the mid-portion of the ETT. A filter was attached at both ends of the ETT to collect the mucus displaced proximally (mouth-piece filter) and distally (lung filter). The IPV machine was attached to the proximal end of the ETT and was applied for 10-min each to Group 1 and 2. After each experiment, the weight of the various circuit components were determined and compared to their dry weights to calculate the weight of the displaced mucus.

RESULTS: In Group 1 (spontaneously breathing model), 26.8% ± 3.1% of the simulated mucus was displaced proximally, compared to 0% in Group 2 (the mechanically ventilated model) with a P-value of < 0.01. In fact, 17% ± 1.5% of the mucus in Group 2 remained in the mid-portion of the ETT where it was initially instilled and 80% ± 4.2% was displaced distally back towards the lung (P < 0.01). There was an overall statistically significant amount of mucus movement proximally towards the mouth-piece in the spontaneously breathing (SB) patient. There was also an overall statistically significant amount of mucus movement distally back towards the lung in the mechanically ventilated (MV) model. In the mechanically ventilated model, no mucus was observed to move towards the proximal/mouth piece section of the ETT.

CONCLUSION: This bench model suggests that IPV is associated with displacement of mucus towards the proximal mouthpiece in the SB patient, and distally in the MV model.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:6

Enthalten in:

World journal of critical care medicine - 6(2017), 3 vom: 04. Aug., Seite 164-171

Sprache:

Englisch

Beteiligte Personen:

Fernandez-Restrepo, Lorena [VerfasserIn]
Shaffer, Lauren [VerfasserIn]
Amalakuhan, Bravein [VerfasserIn]
Restrepo, Marcos I [VerfasserIn]
Peters, Jay [VerfasserIn]
Restrepo, Ruben [VerfasserIn]

Links:

Volltext

Themen:

Breathing exercises
Journal Article
Mechanical ventilators
Mucus
Percussion
Respiratory drainage
Sputum

Anmerkungen:

Date Revised 30.09.2020

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.5492/wjccm.v6.i3.164

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM275013464