The effect of intrapulmonary percussive ventilation in pediatric patients: A systematic review

Abstract

Background: Intrapulmonary percussive ventilation (IPV) is frequently used in clinical practice to enhance sputum evacuation and lung recruitment. However, the evidence in different respiratory pathologies, especially in children, is still lacking. This systematic review aims to enlist the effectiveness of IPV as an airway clearance technique in pediatric patients.

Data sources: A systematic literature search was performed in PubMed, Web of Science, and the Cochrane Library databases.

Study selection: Studies were included if the subjects suffered from a respiratory disease requiring airway clearance and the mean age of the sample was <18 years. After screening, nine articles remained for further analysis.

Results: Three of the nine articles examined patients with cystic fibrosis (CF). No significant differences in lung function or expectorated mucus were found compared to conventional chest physiotherapy. On the other hand, significant beneficial results were found for the treatment or prevention of atelectasis in non-CF patients using IPV. Similar results were seen when comparing therapies for neuromuscular/neurological patients. One study found that IPV reduced hospital stay and improved the clinical status of children with acute bronchiolitis compared to no physiotherapy. Severe adverse events did not occur in the included studies.

Conclusion: A limited number of studies investigated IPV in the pediatric population. Despite the heterogeneity across the studies and the small sample sizes, the results seem promising. IPV is suggested to be a safe and effective alternative for airway clearance. Future research is required to confirm these results and to further analyze the possible benefits in different respiratory pathologies.

Keywords: airway clearance technique; children; physical therapy; respiratory physiotherapy.