The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

COMPARISON OF THE PRESSURE (P) AND TIDAL VOLUME (V_{T}) DELIVERY OF TWO INTRAPULMONARY PERCUSSION VENTILATORS (IPV): HOME UNIT VS. HOSPITAL UNIT.

James J. Lawson* RRT, Robert S. Campbell RRT, Richard D. Branson RRT, Jay A. Johannigman MD, Fred A. Luchette MD, Kenneth Davis Jr. MD. Department of Surgery, University of Cincinnati Medical Center, Cincinnati, OH; * Respiratory Care Department, Kettering Medical Center, Kettering, OH.

INTRODUCTION: IPV (Percussionaire Corp) is a pneumatic positive pressure device used to enhance secretion clearance and recruit lung volume. IPV utilizes a sliding venturi to create a percussive flow waveform at a frequency between 100 and 240 cycles per minute at driving pressures (DP) of 20 to 50 psig. Two models are currently available: 1) home unit powered by compressor, and 2) hospital unit powered by 50 psig source gas. We compared P and V_{T} delivered from each IPV in a lung model. METHOD: Each IPV was attached to one chamber of test lung (TTL, Michigan Instruments) via a simulated trachea (imatrach, Mallinckrodt Medical). TTL settings included compliance (C) of 0.03 and 0.06 L/cmH_{2}O and resistance (R) of 5 and 20 cmH_{2}O/L/sec. DP of each IPV was set to 30, 40, and 50 psig with "percussion" set at 50% of the scope of the control. P was measured proximal to the trachea and within the TTL. V_{T} was integrated from the flow signal measured with a Fleisch pneumotach. Peak lung P, time (T) to attain a P equilibrium (EQ) in the lung, and V_{T} were measured and recorded. Five breaths were manually actuated for 10 seconds and at each setting, were recorded and averaged. P and V_{T} results were compared for each IPV unit using t-test, p < 0.05 was considered significant. Results: Table 1 reveals V_{T} and T to P EQ for home and hospital IPV at each C and R with 50 psig DP. Table 2 reveals mean lung P and V_{T} delivery by home and hospital IPV at 30, 40, and 50 psig DP(C=0.03.R=20).

Table 1

UNIT C=0.06,R=5 C=0.03,R=5 C=0.06,R=20 C=0.06,R=20

V_{T} (mL) Hosp 1199 ± 48 643 ± 34 1225 ± 62 750 ± 38

V_{T} (mL) Home 656 ± 30* 331 ± 24* 629 ± 29* 432 ± 24*

T - EQ (s) Hosp 5.5 ± 0.4 3.9 ± 0.3 6.8 ± 0.5 5.9 ± 0.4

T - EQ (s) Home 4.3 ± 0.3 3.1 ± 0.3 5.5 ± 0.4 3.3 ± 0.3

Table 2

UNIT 30 psig 40 psig 50 psig

V_{T} (mL) Hospital 323 ± 22 536 ± 26 750 ± 38

V_{T} (mL) Home 206 ± 19* 285 ± 20* 432 ± 24*

Lung P (cmH_{2}O) Hospital 10 ± 0.9 16.1 ± 1.1 21.3 ± 1.3

Lung P (cmH_{2}O) Home 8.9 ± 0.8 12.1 ± 0.9* 13.7 ± 1.1*

* = p < 0.05 home IPV vs. hospital IPV

Delivered V_{T} and lung P were lower with the home IPV at all settings. CONCLUSION: P and V_{T} varies between the home and hospital IPV. The difference in P and V_{T} are accentuated at high DP.

OF-97-132

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