Acute effects of intrapulmonary percussive ventilation in COPD patients assessed by using conventional outcome parameters and a novel computational fluid dynamics technique

Abstract

Kris Ides,1–3 Wim Vos,3,4 Lieve De Backer,2,3 Dirk Vissers,1,2 Rita Claes,2,3 Glenn Leemans,1,2 Kevin Ongena,1 Oswald Peters,5 Wilfried De Backer1–31Department of Health Science, Artesis University College of Antwerp, Merksem, 2Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 3Department of Respiratory Medicine, Antwerp University Hospital, Edegem, 4FluidDa.nv, Groeningerlei, Kontich, Belgium, 5AZ Monica, Antwerp, BelgiumObjective: Chest physiotherapy enhances sputum evacuation in COPD patients. It can be applied as a single technique or as a combination of techniques including intrapulmonary percussive ventilation (IPV). Recently developed assessment techniques may provide new insights into the effect of airway clearance techniques.Participants: Five moderate to severe COPD patients (three females and two males; mean forced expiratory volume in 1 second of 39.49% predicted) who were admitted in the hospital for an acute exacerbation were included in this study.Methods: A novel imaging technique was used, together with other conventional techniques, to visualize the short-term effects of a single IPV treatment in COPD patients.Results: No significant changes were noted in the lung function parameters or arterial blood gases measured within 1 hour after the end of the IPV session. Computed tomography images detected changes in the airway patency after the IPV treatment compared with before treatment. Local resistances, calculated for the three-dimensional models, showed local changes in airway resistance.Conclusion: The effects of a single IPV session can be visualized by functional imaging. This functional imaging allows a calculation of changes in local airway resistance and local changes in airway volume in COPD patients without affecting conventional lung function parameters.Keywords: IPV, lung function, forced oscillation technique, physical therapy, airway clearance technique