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Research ArticleOriginal Research

Short-Term Effect of Intermittent Intrapulmonary Deflation on Air Trapping in Patients With COPD

Juliana Ribeiro Fonseca Franco de Macedo, Gregory Reychler, Giuseppe Liistro and William Poncin
Respiratory Care February 2023, respcare.10398; DOI: https://doi.org/10.4187/respcare.10398
Juliana Ribeiro Fonseca Franco de Macedo
Institute de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL and Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.
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  • For correspondence: [email protected]
Gregory Reychler
Institute de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL and Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.
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Giuseppe Liistro
Institute de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL and Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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William Poncin
Institute de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL and Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Secteur de Kinésithérapie et Ergothérapie, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium.
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Abstract

BACKGROUND: Intermittent intrapulmonary deflation is an airway clearance technique that generates negative pressure during expiratory phases. This technology is intended to reduce air trapping by delaying the onset of air-flow limitation during exhalation. The objective of this study was to compare the short-term effect of intermittent intrapulmonary deflation versus positive expiratory pressure (PEP) therapy on trapped gas volume and vital capacity (VC) in patients with COPD.

METHODS: We designed a randomized crossover study in which the participants with COPD received a 20-min session of both intermittent intrapulmonary deflation and PEP therapy on separate days and in random order. Lung volumes were measured via body plethysmography and helium dilution techniques, and spirometric outcomes were reviewed before and after each therapy. The trapped gas volume was estimated via functional residual capacity (FRC), residual volume (RV), and by the difference between FRC obtained through body plethysmography and helium dilution. Each participant also performed 3 VC maneuvers, from total lung capacity to RV with both devices.

RESULTS: Twenty participants with COPD (mean ± SD ages 67 ± 8 y; FEV1 48.1 ± 17.0%) were recruited. There was no difference between the devices in FRC or trapped gas volume. However, the RV decreased more during intermittent intrapulmonary deflation compared with PEP. The intermittent intrapulmonary deflation mobilized a larger expiratory volume than PEP during the VC maneuver (mean difference 389 mL, 95% CI 128–650 mL; P = .003).

CONCLUSIONS: The RV decreased after intermittent intrapulmonary deflation compared with PEP, but this effect was not captured by other estimates of hyperinflation. Although the expiratory volume obtained during the VC maneuver with intermittent intrapulmonary deflation was greater than that obtained with PEP, the clinical importance as well as the long-term effects remain to be determined. (ClinicalTrials.gov registration NCT04157972.)

  • intermittent intrapulmonary deflation
  • lung hyperinflation
  • chronic obstructive pulmonary disease
  • positive expiratory pressure
  • airway clearance technique

Footnotes

  • Correspondence: Juliana Ribeiro Fonseca Franco de Macedo PT, Department of Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10–1200, Brussels, Belgium. E-mail: demacedo.franco{at}gmail.com
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Respiratory Care: 68 (3)
Respiratory Care
Vol. 68, Issue 3
1 Mar 2023
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Short-Term Effect of Intermittent Intrapulmonary Deflation on Air Trapping in Patients With COPD
Juliana Ribeiro Fonseca Franco de Macedo, Gregory Reychler, Giuseppe Liistro, William Poncin
Respiratory Care Feb 2023, respcare.10398; DOI: 10.4187/respcare.10398

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Short-Term Effect of Intermittent Intrapulmonary Deflation on Air Trapping in Patients With COPD
Juliana Ribeiro Fonseca Franco de Macedo, Gregory Reychler, Giuseppe Liistro, William Poncin
Respiratory Care Feb 2023, respcare.10398; DOI: 10.4187/respcare.10398
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Keywords

  • intermittent intrapulmonary deflation
  • lung hyperinflation
  • chronic obstructive pulmonary disease
  • positive expiratory pressure
  • airway clearance technique

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