Oscillatory positive expiratory pressure treatment in lower respiratory tract infection

Ni,Yingmeng; Ding,Lin; Yu,Youchao; Dai,Ranran; Chen,Hong; Shi,Guochao

doi:10.3892/etm.2018.6552

October-2018 Volume 16 Issue 4

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October-2018 Volume 16 Issue 4

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Article

Oscillatory positive expiratory pressure treatment in lower respiratory tract infection

Authors:
- Yingmeng Ni
- Lin Ding
- Youchao Yu
- Ranran Dai
- Hong Chen
- Guochao Shi
View Affiliations / Copyright

Affiliations: Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
Pages: 3241-3248
|
Published online on: August 1, 2018

https://doi.org/10.3892/etm.2018.6552
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Abstract

Oscillatory positive expiratory pressure (OPEP) devices have been utilized as an adjunct therapy to conventional chest physiotherapy (CPT) to promote the clearance of respiratory secretions in individuals with impaired ability to cough, particularly in chronic diseases. However, few studies have focused on the effectiveness of OPEP in lower respiratory tract infection. In the present study, all patients with lower respiratory tract infections hospitalized in the Department of Pulmonary and Critical Care Medicine, Ruijin Hospital (Shanghai, China) between February 2016 and July 2017 were analyzed. Daily sputum quantity and purulence were recorded on the first 7 days of physiotherapy. Oxygenation index, partial pressure carbon dioxide, white blood cell count, neutrophil percentage, C reactive protein (CRP) and procalcitonin (PCT) levels before and after CPT were compared between patients who received OPEP and patients who received mechanical percussion (MP). Sputum was collected prior to and following CPT. A total of 17 patients received OPEP, while 10 received MP. The OPEP group exhibited improved postural drainage compared with the MP group after 7 days of physiotherapy. After 7 days of CPT, patients who received OPEP also exhibited a significantly improved oxygenation index, while the oxygenation index in the MP group did not improve. The improvement of partial pressure carbon dioxide was not significantly different between groups. The OPEP group also exhibited a greater decrease in white blood cell count, neutrophil percentage and CRP levels, compared with the MP group. However, the decrease in PCT level was similar in the OPEP and MP groups. Sputum culture results revealed that the rate of negative conversion was very low in both groups. There was no difference between the two groups in terms of hospitalization outcomes. In conclusion, OPEP exhibited a greater effectiveness in draining sputum, improving oxygenation and reducing inflammatory status in patients with lower respiratory tract infections compared with MP; however, it did not promote the elimination of microbes.

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1	Arens R, Gozal D, Omlin KJ, Vega J, Boyd KP, Keens TG and Woo MS: Comparison of high-frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis. Am J Respir Crit Care Med. 150:1154–1157. 1994. View Article : Google Scholar : PubMed/NCBI
2	Pryor JA: Physiotherapy for airway clearance in adults. Eur Respir J. 14:1418–1424. 1999. View Article : Google Scholar : PubMed/NCBI
3	Oberwaldner B, Evans JC and Zach MS: Forced expirations against a variable resistance: A new chest physiotherapy method in cystic fibrosis. Pediatr Pulmonol. 2:358–367. 1986. View Article : Google Scholar : PubMed/NCBI
4	Groth S, Stafanger G, Dirksen H, Andersen JB, Falk M and Kelstrup M: Positive expiratory pressure (PEP-mask) physiotherapy improves ventilation and reduces volume of trapped gas in cystic fibrosis. Bull Eur Physiopathol Respir. 21:339–343. 1985.PubMed/NCBI
5	McIlwaine M: Physiotherapy and airway clearance techniques and devices. Paediatr Respir Rev. 7 Suppl 1:S220–S222. 2006. View Article : Google Scholar : PubMed/NCBI
6	Konstan MW, Stern RC and Doershuk CF: Efficacy of the Flutter device for airway mucus clearance in patients with cystic fibrosis. J Pediatr. 124:689–693. 1994. View Article : Google Scholar : PubMed/NCBI
7	Girard JP and Terki N: The Flutter VRP1: A new personal pocket therapeutic device used as an adjunct to drug therapy in the management of bronchial asthma. J Investig Allergol Clin Immunol. 4:23–27. 1994.PubMed/NCBI
8	Burioka N, Sugimoto Y, Suyama H, Hori S, Chikumi H and Sasaki T: Clinical efficacy of the FLUTTER device for airway mucus clearance in patients with diffuse panbronchiolitis. Respirology. 3:183–186. 1998. View Article : Google Scholar : PubMed/NCBI
9	Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P and Barlascini C: Comparison of effectiveness of temporary positive expiratory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 12:1274–1282. 2018. View Article : Google Scholar : PubMed/NCBI
10	Narula D and Nangia V: Use of an oscillatory PEP device to enhance bronchial hygiene in a patient of post-H1NI pneumonia and acute respiratory distress syndrome with pneumothorax. BMJ Case Rep. 2014:pii: bcr2013202598. 2014. View Article : Google Scholar : PubMed/NCBI
11	Castro AA, Calil SR, Freitas SA, Oliveira AB and Porto EF: Chest physiotherapy effectiveness to reduce hospitalization and mechanical ventilation length of stay, pulmonary infection rate and mortality in ICU patients. Respir Med. 107:68–74. 2013. View Article : Google Scholar : PubMed/NCBI
12	Zach MS and Oberwaldner B: Chest physiotherapy-the mechanical approach to antiinfective therapy in cystic fibrosis. Infection. 15:381–384. 1987. View Article : Google Scholar : PubMed/NCBI
13	Maxwell M and Redmond A: Comparative trial of manual and mechanical percussion technique with gravity-assisted bronchial drainage in patients with cystic fibrosis. Arch Dis Child. 54:542–544. 1979. View Article : Google Scholar : PubMed/NCBI
14	Alves CE, Nunes LQ and Melo PL: Mechanical analysis of an oscillatory positive expiratory pressure device used in respiratory rehabilitation. Conf Proc IEEE Eng Med Biol Soc. 2010:2477–2480. 2010.PubMed/NCBI
15	Carrera E, Kim DJ, Castellani G, Zweifel C, Smielewski P, Pickard JD and Czosnyka M: Effect of hyper- and hypocapnia on cerebral arterial compliance in normal subjects. J Neuroimaging. 21:121–125. 2011. View Article : Google Scholar : PubMed/NCBI
16	Wu Y, Potempa LA, El Kebir D and Filep JG: C-reactive protein and inflammation: Conformational changes affect function. Biol Chem. 396:1181–1197. 2015. View Article : Google Scholar : PubMed/NCBI
17	Newhouse PA, White F, Marks JH and Homnick DN: The intrapulmonary percussive ventilator and flutter device compared to standard chest physiotherapy in patients with cystic fibrosis. Clin Pediatr (Phila). 37:427–432. 1998. View Article : Google Scholar : PubMed/NCBI
18	Volsko TA, DiFiore JM and Chatburn RL: Performance comparison of two oscillating positive expiratory ressure devices: Acapella versus flutter. Respir Care. 48:124–130. 2003.PubMed/NCBI
19	Van Fleet H, Dunn DK, McNinch NL and Volsko TA: Evaluation of functional characteristics of 4 oscillatory positive pressure devices in a simulated cystic fibrosis model. Respir Care. 62:451–458. 2017. View Article : Google Scholar : PubMed/NCBI
20	Myers TR: Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care. 52:1308–1327. 2007.PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Oscillatory positive expiratory pressure treatment in lower respiratory tract infection

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