The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Kathleen R. Spihlman, Peggy Watts, Darnetta Clinkscale, Marin Kollef, John Dallas; Respiratory Care, Barnes-Jewish Hospital, St. Louis, MO

BACKGROUND: Conventional chest physical therapy (CPT) has become the standard to which all other bronchial hygiene techniques are compared. The objective of this investigation was to compare the clinical outcomes of hospitalized patients treated with The Vest® Airway Clearance System (the Vest®) vs. CPT. METHODS: Hospitalized patients with a CPT order were randomized to receive therapy consisting of the Vest® or conventional CPT. The Vest® facilitates removal of secretions from the lungs utilizing an air pulse generator and an inflatable vest to create high frequency chest wall oscillation (HFCWO). The primary outcome measure was the number of hospital free days. Hospital free days are defined as the number of days free from hospitalization during the study enrollment period [30 days]. A patient satisfaction rating, as measured by using a comfort scale, was a secondary outcome measure. RESULTS: Patients ordered by a physician to received CPT and met the Barnes-Jewish Hospital Chest Physical Therapy Protocol criteria were approached to participate in the study. Two hundred and thirty-seven patients have completed the study. The Vest® group (n = 113) and the CPT group (n = 124) had no significant differences in their baseline characteristics at the time of entry into the study. No significant difference exists in the number of hospital free days between the Vest® group 17.1 ± 8.8 days and the CPT group 17.6 ± 8.9 days, respectively; p = 0.664. Lobar atelectasis in Vest® patients 78 (69.0%) versus in CPT patients 84 (67.7%) p = 0.832. Lobar atelectasis resolved in Vest® patients 42 (37.2%) versus in CPT patients 48 (38.7%) p = 0.807. Significant difference exists in patient satisfaction ratings (2.0 ± 0.7 vs. 2.2 ± 0.8, respectively; p = 0.028). The patient satisfaction or comfort associated with the Vest® was statistically lower (meaning more comfortable) for the Vest® versus CPT. Staff were surveyed following a two year study with a response rate of 96%. Of those surveyed 98% would likely to extremely likely recommend the Vest® for patient therapy and 85% would personally choose the Vest® if in need of CPT themselves. CONCLUSIONS: The analysis of clinical outcomes shows no statistical difference between the Vest® and CPT group. The Vest® does show a statistical difference in patient satisfaction measured with a patient comfort score. DISCLOSURES: This study was supported by Hill-Rom. Sponsored Research - Hill-Rom Staff Survey Results