Additional consequences of pulmonary infections include exposure to multiple courses of antibiotics with associated risks of acquisition of antibiotic-resistant microorganisms, antibiotic-associated colitis, and medical complications associated with hospitalization in an intensive care setting. Respiratory infections prevent patients from attending school, rehabilitative or recreational programs. 2, 3 They are predisposed to atelectasis, retention of airway secretions, and respiratory infection. 1 Patients with NMD have ineffective muscle function, which results in small tidal volumes and reduced cough effectiveness. Pulmonary complications are common and can be life threatening in patients with neuromuscular diseases (NMD). The IPV group had 0 episodes of pneumonia or bacterial bronchitis compared with 3 events in the IS group, although this did not meet statistical significance.Ĭonclusion Intrapulmonary percussive ventilation as part of a preventive pulmonary regimen reduced days of antibiotic use and hospitalization for respiratory illness in adolescents with neuromuscular disease. The IS group spent more days hospitalized (4.4/1000 patient-days vs 0/1000 patient-days) than the IPV group (incidence rate ratio, 8.5 95% confidence interval, 1.1-67). Antibiotic use was significantly higher with IS (24/1000 patient-days) compared with IPV (0/1000 patient-days), (incidence rate ratio, 43 95% confidence interval, 6-333). Results A total of 18 patients were enrolled (9 IPV, 9 IS). The secondary endpoints were the number of respiratory infections, hospitalizations, and school days missed. Methods A randomized, controlled study was conducted to compare efficacy of IPV with incentive spirometry (IS) in reducing number of days of antibiotic use in adolescents with neuromuscular disease. Objective To test the hypothesis that IPV used in a pulmonary program for adolescents with neuromuscular disease would reduce the number of days of antibiotic use for pulmonary infection. Anecdotal reports and pilot studies show its safety and effectiveness in mobilizing secretions in patients with cystic fibrosis. Intrapulmonary percussive ventilation (IPV) is a pneumatic device that delivers air and aerosol to the lungs at frequencies of 200 to 300 cycles per minute at peak pressures from 20 to 40 cm H 2O. Shared Decision Making and Communicationīackground Pulmonary infections can be life threatening for children with neuromuscular diseases who have impaired ability to clear secretions.Scientific Discovery and the Future of Medicine.
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