RT Journal Article SR Electronic T1 The Short-Term Effects of Intermittent Positive Pressure Breathing Treatments on Ventilation in Patients With Neuromuscular Disease JF Respiratory Care FD American Association for Respiratory Care SP 866 OP 872 VO 55 IS 7 A1 Claude Guérin A1 Bernard Vincent A1 Thierry Petitjean A1 Pierre Lecam A1 Christiane Luizet A1 Muriel Rabilloud A1 Jean-Christophe Richard YR 2010 UL http://rc.rcjournal.com/content/55/7/866.abstract AB BACKGROUND: The effects of intermittent positive-pressure breathing (IPPB) and abdominal belt on regional lung ventilation in neuromuscular patients are unknown. We conducted a prospective physiologic short-term study in stable neuromuscular patients to determine the effects of IPBB, with and without abdominal belt, on regional lung ventilation. METHODS: IPPB was performed as 30 consecutive deep breaths up to 30 cm H2O face-mask pressure each: 10 in supine position, 10 in left-lateral position, and 10 in right-lateral position. Each patient received IPPB sessions with and without an abdominal belt, in a random order, at one-day intervals. Patients were then followed-up to 3 hours after IPPB. Lung ventilation was measured via electrical-impedance tomography (tidal volume via electrical-impedance tomography [electrical-impedance VT], which is reported in arbitrary units) in 4 lung quadrants. Baseline VT and exhaled VT after each deep breath were also measured. The primary outcome was maintenance of regional ventilation after 3 hours. RESULTS: Global electrical-impedance VT remained significantly higher than at baseline as long as 3 hours after the IPPB sessions. Global and regional electrical-impedance VT at the end of the 3-hour study period was significantly higher with the abdominal belt in place. Regional ventilation did not change significantly. With IPPB in the supine position, electrical-impedance VT was significantly greater in the anterior than the posterior lung regions (P < .001). With IPPB in supine position, median and interquartile range VT values increased from 0.25 L (0.20–0.30) to the exhaled VT of 1.50 L (1.08–1.96) (P < .001). There were no differences in regional ventilation. CONCLUSIONS: In patients with neuromuscular disease, supine IPPB treatments, with or without abdominal belt, increased ventilation to anterior lungs regions, compared to the left-lateral and right-lateral positions. Global ventilation 3 hours after IPPB treatments remained higher than at baseline and was best preserved with the use of an abdominal belt.