Comparison of intermittent positive pressure breathing and temporary positive expiratory pressure in patients with severe chronic obstructive pulmonary disease.

Autor: Nicolini A; Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia. Electronic address: antonello.nicolini@fastwebnet.it., Mollar E; Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia., Grecchi B; Departamento de Rehabilitación, ASL4 Chiavarese, Chiavari, Italia., Landucci N; Unidad de Enfermedades Respiratorias, Hospital General de Sestri Levante, Sestri Levante, Italia.
Jazyk: English; Spanish; Castilian
Zdroj: Archivos de bronconeumologia [Arch Bronconeumol] 2014 Jan; Vol. 50 (1), pp. 18-24. Date of Electronic Publication: 2013 Dec 08.
DOI: 10.1016/j.arbres.2013.07.019
Abstrakt: Background: Results supporting the use and the effectiveness of positive expiratory, pressure devices in chronic obstructive pulmonary disease (COPD) patients are still controversial, We have tested the hypothesis that adding TPEP or IPPB to standard pharmacological therapy may provide additional clinical benefit over, pharmacological therapy only in patients with severe COPD.
Methods: Fourty-five patients were randomized in three groups: a group was treated; with IPPB,a group was treated with TPEP and a group with pharmacological; therapy alone (control group). Primary outcome measures included the measurement of scale or, questionnaire concerning dyspnea (MRC scale),dyspnea,cough, and, sputum (BCSS) and quality of life (COPD assessment test) (CAT). Secondary, outcome measures were respiratory function testing,arterial blood gas,analysis,and hematological examinations.
Results: Both patients in the IPPB group and in the TPEP group showed a significant, improvement in two of three tests (MRC,CAT) compared to the control, group.However,in the group comparison analysis for, the same variables between IPPB group and TPEP group we observed a, significant improvement in the IPPB group (P≤.05 for MRC and P≤.01 for, CAT). The difference of action of the two techniques are evident in the results of, pulmonary function testing: IPPB increases FVC, FEV1, and MIP; this reflects, its capacity to increase lung volume. Also TPEP increases FVC and FEV1 (less, than IPPB), but increases MEP, while decreasing total lung capacity and, residual volume.
Conclusions: The two techniques (IPPB and TPEP) improves significantly dyspnea; quality of; life tools and lung function in patients with severe COPD. IPPB demonstrated a greater effectiveness to improve dyspnea and quality of life tools (MRC, CAT) than TPEP.
(Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.)
Databáze: MEDLINE
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