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Extubation failure in intensive care unit: predictors and management
Kulkarni, A.P., et al. Indian Journal of Critical Care Medicine. 2008.
"The most common cause [of extubation failure] is respiratory failure... excessive secretions, coupled with inadequate muscle strength and glottic incompetence can also cause failed extubation."
Effect of intrapulmonary percussive ventilation on expiratory flow limitation in chronic obstructive pulmonary disease patients
Vargas, F., et al. Journal of Critical Care. 2009.
In a study of COPD patients weaning from mechanical ventilation, IPV therapy significantly reduced expiratory flow limitation (EFL). IPV decreased EFL in 96% of patients, with EFL dropping from 65.4% before IPV to 35.4% after treatment.
Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD
Nicolini, A., et al. The International Journal of Chronic Obstructive Pulmonary Disease. 2018.
In a randomized, controlled study of 60 COPD patients, IPV therapy significantly improved dyspnea, daily activities, pulmonary function, and arterial blood gas values compared to the control group receiving Chest Physical Therapy (CPT) alone.
Physiological response to intrapulmonary percussive ventilation in stable COPD patients
Nava, S., et al. Respiratory Medicine. 2006.
In a study on IPV therapy in COPD patients, researchers found that IPV significantly increased tidal volumes and reduced diaphragm effort compared to baseline. Minute ventilation stayed constant, and tolerance was good across different IPV settings.
High frequency percussive airway clearance utilizing two devices in simulation of mucous clearance, without spontaneous breathing, both with and without mechanical ventilation
Conomon, D., et al. Respiratory Care. 2021.
In a 2021 bench test, researchers found that, even with similar settings, OLE cleared less simulated mucus than IPV therapy. IPV cleared 61.96% of mucus versus 17.54% for OLE with invasive ventilation, and 55.33% versus 4.89% without invasive ventilation.
Intrapulmonary percussive ventilation in acute exacerbations of COPD patients with mild respiratory acidosis
Vargas, F., et al. Critical Care. 2005.
In a study of 33 COPD patients with exacerbations, 6 of 17 patients in the control group worsened, while none of the 16 patients treated with IPV therapy worsened. Additionally, the IPV group had a shorter hospital stay (6.8 days) compared to the control group (7.9 days).
Effect of intrapulmonary percussive ventilation on mucus clearance in duchenne muscular dystrophy patients: a preliminary report
Toussaint, M., et al. Respiratory Care. 2003.
In patients with Duchenne muscular dystrophy, IPV therapy significantly increased the mean weight of secretions compared to CPT alone. Secretions collected by endotracheal suctioning rose by 68.7% with IPV plus CPT, versus a 7.0% increase with CPT alone.
Risk factors for and prediction by caregivers of extubation failure in ICU patients: a prospective study
Thille, A.W., et al. Critical Care Medicine. 2015.
In over 500 intubated patients, extubation failure was linked to longer ventilation, ICU-acquired paresis, ineffective cough, abundant secretions, and more. Only one-third patients who required reintubation were considered at high risk for extubation failure by caregivers.
Frequent tracheal suctioning is associated with extubation failure in patients with successful spontaneous breathing trial
Carbon dioxide monitoring during long-term noninvasive respiratory support in children
Paiva R., et al. Intensive Care Medicine. 2009.
This study of 50 pediatric patients on noninvasive respiratory support shows that SpO2 and daytime ABGs are inadequate for detecting nighttime hypercapnia.
