• Frédéric Vargas, Hoang Nam Bui, Alexandre Boyer, Louis Rachid Salmi, Georges Gbikpi-Benissan, Hervé Guenard, Didier Gruson, and Gilles Hilbert.
• Département de Réanimation Médicale, Hôpital Pellegrin-Tripode, Bordeaux, France. frederic.vargas@chu-bordeaux.fr
• Crit Care. 2005 Aug 1; 9 (4): R382-9.

IntroductionWe hypothesized that the use of intrapulmonary percussive ventilation (IPV), a technique designed to improve mucus clearance, could prove effective in avoiding further deterioration in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) with mild respiratory acidosis.MethodsThe study was performed in a medical intensive care unit of a university hospital. Thirty-three patients with exacerbations of COPD with a respiratory frequency >or= 25/min, a PaCO2 > 45 Torr and 7.35 ResultsThirty minutes of IPV led to a significant decrease in respiratory rate, an increase in PaO2 and a decrease in PaCO2 (p < 0.05). Exacerbation worsened in 6 out of 17 patients in the control group versus 0 out of 16 in the IPV group (p < 0.05). The hospital stay was significantly shorter in the IPV group than in the control group (6.8 +/- 1.0 vs. 7.9 +/- 1.3 days, p < 0.05).ConclusionIPV is a safe technique and may prevent further deterioration in patients with acute exacerbations of COPD with mild respiratory acidosis.

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