Original articleGeneral thoracicManagement of Localized Pneumothoraces After Pulmonary Resection With Intrapulmonary Percussive Ventilation
Section snippets
Material and Methods
Between January 2005 and March 2009, four patients with persistent localized pneumothoraces after pulmonary resection (mean, 187 days) were treated with IPV after failing medical treatment and physiotherapy (Table 1). There were 3 males and one female with a mean age of 64 years; two patients were current and two were former smokers. Mean preoperative and immediate postsurgical forced expiratory volume in the first second of expiration (FEV1) were 2.31 L and 1.49 L, respectively. Mean
Results
Complete lung reexpansion was obtained in all patients (Fig 1) within three weeks of beginning of treatment (mean, 22 days). Mean immediate postsurgical FEV1 and FVC were 1.49 L and 2.1 L, respectively. Mean FEV1 and FVC measured after IPV increased by 8.7% and 9.6% compared with immediate postsurgical FEV1 and FVC, respectively. Total loss of mean FEV1 and FVC compared with preoperative values was 17.7% and 14.7%, respectively. Moreover, Dlco measured at the end of IPV treatment was 83.7%;
Comment
Intrapulmonary percussive ventilation, a term coined by Bird in the 1980s [1], belongs to the modalities of noninvasive ventilation aimed at clearing secretions and enhancing oxygenation, especially in pediatric patients with cystic fibrosis [3, 4]. Reportedly, IPV facilitates airway clearance and expansion through “radial displacement” of the bronchial wall and by generating pulsatile expiratory flows of greater magnitude than the inspiratory ones at each respiratory cycle [5]. From a clinical
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