https://doi.org/10.4081/monaldi.2024.2734
Feasibility of high-frequency percussions in people with severe acquired brain injury and tracheostomy: an observational study
Submitted: July 31, 2023
Accepted: January 2, 2024
Published: January 17, 2024
Accepted: January 2, 2024
Abstract Views: 586
PDF_EARLY VIEW: 327
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
People with severe acquired brain injury (pwSABI) frequently experience pulmonary complications. Among these, atelectasis can occur as a result of pneumonia, thus increasing the chance of developing acute respiratory failure. Respiratory physiotherapy contribution to the management of atelectasis in pwSABI is yet poorly understood. We conducted a retrospective analysis on 15 non-cooperative pwSABI with tracheostomy and spontaneously breathing, hospitalized and treated with high-frequency percussion physiotherapy between September 2018 and February 2021 at the Neurological Rehabilitation Unit of the IRCCS “S.Maria Nascente - Fondazione Don Gnocchi”, Milan. Our primary aim was to investigate the feasibility of such a physiotherapy intervention method. Then, we assessed changes in respiratory measures (arterial blood gas analysis and peripheral night-time oxygen saturation) and high-resolution computed tomography lung images, evaluated before and after the physiotherapy treatment. The radiological measures were a modified radiological atelectasis score (mRAS) assigned by two radiologists, and an opacity score automatically provided by the software CT Pneumonia Analysis® that identifies the regions of abnormal lung patterns. Treatment diaries showed that all treatments were completed, and no adverse events during treatment were registered. Among the 15 pwSABI analyzed, 8 were treated with IPV® and 7 with MetaNeb®. After a median of 14 (I-III quartile=12.5-14.5) days of treatment, we observed a statistical improvement in various arterial blood gas measures and peripheral night-time oxygen saturation measures. We also found radiological improvement or stability in more than 80% of pwSABI. In conclusion, our physiotherapy approach was feasible, and we observed respiratory parameters and radiological improvements. Using technology to assess abnormal tomographic patterns could be of interest to disentangle the short-term effects of respiratory physiotherapy on non-collaborating people.
Goyal K, Hazarika A, Khandelwal A, et al. Non-neurological complications after traumatic brain injury: a prospective observational study. Indian J Crit Care Med 2018;22:632-8.
DOI: https://doi.org/10.4103/ijccm.IJCCM_156_18
Lim HB, Smith M. Systemic complications after head injury: a clinical review. Anaesthesia 2007;62:474-82.
DOI: https://doi.org/10.1111/j.1365-2044.2007.04998.x
Hu PJ, Pittet JF, Kerby JD, et al. Acute brain trauma, lung injury, and pneumonia: more than just altered mental status and decreased airway protection. Am J Physiol Lung Cell Mol Physiol 2017;313:L1-L15.
DOI: https://doi.org/10.1152/ajplung.00485.2016
Zygun DA, Kortbeek JB, Fick GH, et al. Non-neurologic organ dysfunction in severe traumatic brain injury. Crit Care Med 2005;33:654-60.
DOI: https://doi.org/10.1097/01.CCM.0000155911.01844.54
Scarponi F, Zampolini M, Zucchella C, et al. Identifying clinical complexity in patients affected by severe acquired brain injury in neurorehabilitation: a cross sectional survey. Eur J Phys Rehabil Med 2019;55:191-8.
DOI: https://doi.org/10.23736/S1973-9087.18.05342-X
Baltazar GA, Chendrasekhar A, Akella K, et al. Pulmonary hygiene protocol reduces incidence of lobar collapse in severe traumatic brain injury. Cureus 2020;12:e12199.
DOI: https://doi.org/10.7759/cureus.12199
Riffard G, Toussaint M. Indications for intrapulmonary percussive ventilation (IPV): a review of the literature. Rev Mal Respir 2012;29:178-90. [Article in French].
DOI: https://doi.org/10.1016/j.rmr.2011.12.005
Stephens MA. EDF statistics for goodness of fit and some comparisons. J Am Stat Assoc 1974;69:730-7.
DOI: https://doi.org/10.1080/01621459.1974.10480196
Clini EM, Antoni FD, Vitacca M, et al. Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med 2006;32:1994-2001.
DOI: https://doi.org/10.1007/s00134-006-0427-8
Reychler G, Debier E, Contal O, Audag N. Intrapulmonary percussive ventilation as an airway clearance technique in subjects with chronic obstructive airway diseases. Respir Care 2018;63:620-31.
DOI: https://doi.org/10.4187/respcare.05876
Ferguson A, Wright S. Innovative chest physiotherapy techniques (the MetaNeb® System) in the intubated child with extensive burns. Respir Med Case Rep 2017;22:232-4.
DOI: https://doi.org/10.1016/j.rmcr.2017.08.020
Huynh T, Cereda M, Diette G, Liesching T. 17: treatment with metaneb therapy reduces postoperative pulmonary complications: a multicenter trial. Crit Care Med 2018;46:9.
DOI: https://doi.org/10.1097/01.ccm.0000528073.39760.76
Thoracic Surgery at Royal Victoria Hospital, Belfast. Available from: https://www.mactheknife.org/Scoring_systems/Atelectasis.html. Accessed on: 13/12/2023.
R: the R project for statistical computing. Available from: https://www.r-project.org/. Accessed on: 5/07/2023.
Corral L, Javierre CF, Ventura JL, et al. Impact of non-neurological complications in severe traumatic brain injury outcome. Crit Care 2012;16:R44.
DOI: https://doi.org/10.1186/cc11243
Whyte J, Nordenbo AM, Kalmar K, et al. Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness. Arch Phys Med Rehabil 2013;94:1877-83.
DOI: https://doi.org/10.1016/j.apmr.2012.12.027
Tzeng AC, Bach JR. Prevention of pulmonary morbidity for patients with neuromuscular disease. Chest 2000;118:1390-6.
DOI: https://doi.org/10.1378/chest.118.5.1390
Wu H, Gong L, Qian Z, Mao Q. Analysis of the influencing factors and nursing strategy for acute atelectasis after traumatic brain injury surgery. Ann Palliat Med 2021;10:5425-32.
DOI: https://doi.org/10.21037/apm-21-790
Van Wessem KJP, Leenen LPH. Incidence of acute respiratory distress syndrome and associated mortality in a polytrauma population. Trauma Surg Acute Care Open 2018;3:e000232.
DOI: https://doi.org/10.1136/tsaco-2018-000232
Toussaint M, Guillet MC, Paternotte S, et al. Intrapulmonary effects of setting parameters in portable intrapulmonary percussive ventilation devices. Respir Care 2012;57:735-42.
DOI: https://doi.org/10.4187/respcare.01441
Yen Ha TK, Bui TD, Tran AT, et al. Atelectatic children treated with intrapulmonary percussive ventilation via a face mask: clinical trial and literature overview. Pediatr Int 2007;49:502-7.
DOI: https://doi.org/10.1111/j.1442-200X.2007.02385.x
Hassan A, Milross M, Lai W, et al. Feasibility and safety of intrapulmonary percussive ventilation in spontaneously breathing, non-ventilated patients in critical care: a retrospective pilot study. J Intensive Care Soc 2021;22:111-9.
DOI: https://doi.org/10.1177/1751143720909704
Huynh TT, Liesching TN, Cereda M, et al. Efficacy of oscillation and lung expansion in reducing postoperative pulmonary complication. J Am Coll Surg 2019;229:458-66.e1.
DOI: https://doi.org/10.1016/j.jamcollsurg.2019.06.004
Nava S, Barbarito N, Piaggi G, et al. Physiological response to intrapulmonary percussive ventilation in stable COPD patients. Respir Med 2006;100:1526-33.
DOI: https://doi.org/10.1016/j.rmed.2006.01.010
Ghetti C, Ortenzia O, Bertolini M, et al. Lung dual energy CT: impact of different technological solutions on quantitative analysis. Eur J Radiol 2023;163:110812.
DOI: https://doi.org/10.1016/j.ejrad.2023.110812
Pera Ó, Martínez Á, Möhler C, et al. Clinical validation of Siemens’ Syngo.via automatic contouring system. Adv Radiat Oncol 2023;8:101177.
DOI: https://doi.org/10.1016/j.adro.2023.101177
Gaudreault M, Korte J, Bucknell N, et al. Comparison of dual-energy CT with positron emission tomography for lung perfusion imaging in patients with non-small cell lung cancer. Phys Med Biol 2023;68.
DOI: https://doi.org/10.1088/1361-6560/acb198
Javed S, Zhang Y, Wan D, et al. Identification of anatomical types of segmental bronchi in right middle lobe using multi-slice CT. Surg Radiol Anat 2023;45:819-25.
DOI: https://doi.org/10.1007/s00276-023-03159-y
Marini JJ. Acute lobar atelectasis. Chest 2019;155:1049-58.
DOI: https://doi.org/10.1016/j.chest.2018.11.014
Dagan K. A comparison of intrapulmonary percussive ventilation and conventional chest physical therapy for COPD patients hospitalized for acute exacerbation. Available from: https://www.ers-education.org/lr/show-details/?idP=185002. Accessed on: 5/07/2023.
Tsuruta R, Kasaoka S, Okabayashi K, Maekawa T. Efficacy and safety of intrapulmonary percussive ventilation superimposed on conventional ventilation in obese patients with compression atelectasis. J Crit Care 2006;21:328-32.
DOI: https://doi.org/10.1016/j.jcrc.2006.03.008
Caldwell KB. A novel ventilatory technique in refractory hypoxemic respiratory failure secondary to therapeutic thoracentesis and paracentesis. Am J Case Rep 2020;21:e924862.
DOI: https://doi.org/10.12659/AJCR.924862
Mertens P. Alveolar-arterial PCO2 differences and diffusion limitation. Lung 1981;159:101-8.
DOI: https://doi.org/10.1007/BF02713903
Petersson J, Glenny RW. Gas exchange and ventilation-perfusion relationships in the lung. Eur Respir J 2014;44:1023-41.
DOI: https://doi.org/10.1183/09031936.00037014
Ethics Approval
The study protocol was approved by the Ethical Review Committee of IRCCS Fondazione Don Carlo Gnocchi IRCCS Regione Lombardia, (protocol no. 05_17/02/2021 dated 21/02/17). The protocol was registered in clinicalTrials.gov (NCT05630079).How to Cite
Sciurello, Salvatore Andrea, Francesca Graziano, Maria Marcella Laganà, Elena Compalati, Gabriele Pappacoda, Simone Gambazza, Jorge Navarro, Pietro Cecconi, Francesca Baglio, and Paolo Banfi. 2024. “Feasibility of High-Frequency Percussions in People With Severe Acquired Brain Injury and Tracheostomy: An Observational Study”. Monaldi Archives for Chest Disease, January. https://doi.org/10.4081/monaldi.2024.2734.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- A. Nicolini, A. Perazzo, Influenza A H1N1 pneumonia in a patient with hairy-cell leukemia , Monaldi Archives for Chest Disease: Vol. 73 No. 2 (2010): Pulmonary series
- Francesca Donati, Leonardo Misuraca, Chrysanthos Grigoratos, Caterina Violo, Stefano Vannucci, Alberto Balbarini, An uncommon clinical condition: chronic thrombosis of the inferior vena cava. A case report and review of literature , Monaldi Archives for Chest Disease: Vol. 74 No. 1 (2010): Cardiac series
- Francesco Borgia, Luigi Di Serafino, Anna Sannino, Giuseppe Gargiulo, Gabriele Giacomo Schiattarella, Mario De Laurentis, Laura Scudiero, Cinzia Perrino, Federico Piscione, Giovanni Esposito, Massimo Chiariello, AngioJet® rheolytic thrombectomy for acute superficial femoral artery stent or femoropopliteal by-pass thrombosis , Monaldi Archives for Chest Disease: Vol. 74 No. 2 (2010): Cardiac series
- M. Patelli, D. Paioli, R. Trisolini, Bronchoscopic Curative Therapy , Monaldi Archives for Chest Disease: Vol. 75 No. 1 (2011): Pulmonary series
- A. Estella, L. Pérez Bello Fontaiña, Sea drowning: a case report and review of the literature , Monaldi Archives for Chest Disease: Vol. 75 No. 2 (2011): Pulmonary series
- L. Casali, M.E. Crapa, The administration of aerosolised medications in bronchiectasis: the rediscovery of an old method , Monaldi Archives for Chest Disease: Vol. 75 No. 3 (2011): Pulmonary series
- Pompilio Faggiano, Marta Scodro, Marco Sbolli, Luca Branca, Dario Cani, Francesca Valentini, Carlotta Perego, Martino Provini, Blood pressure control in older patients with carotid artery stenosis , Monaldi Archives for Chest Disease: Vol. 88 No. 2 (2018)
- Cuneyt Tetikkurt, Bahar Kubat, Seza Tetikkurt, Gulsum Karakas, An atypical acute exacerbation of COPD due to Aspergillus fumigatus , Monaldi Archives for Chest Disease: Vol. 90 No. 1 (2020)
- R. Scala, Bi-level home ventilators for non invasive positive pressure ventilation , Monaldi Archives for Chest Disease: Vol. 61 No. 4 (2004): Pulmonary series
- I.P. Neuringer, S.H. Randell, Lung Stem Cell Update: Promise and Controversy , Monaldi Archives for Chest Disease: Vol. 65 No. 1 (2006): Pulmonary series
<< < 50 51 52 53 54 55 56 57 58 59 > >>
You may also start an advanced similarity search for this article.
