Abstract
Although intrapulmonary percussive ventilation (IPV) is beneficial for improving gas exchange in acute respiratory failure (ARF), the mechanisms have not been clearly elucidated. The effects of IPV on gas exchange were compared with those of PEEP without percussion. A controlled, crossover study was conducted to compare the two types of ventilation [synchronized intermittent mandatory ventilation (SIMV) + PEEP with superimposed IPV, and SIMV + increased PEEP] in eight patients with ARF requiring mechanical ventilation. Changes in blood gases were evaluated after the ventilation at the same mean airway pressure. There was no difference in the improvement of the P/F ratio between the two types of ventilation; however, there was a greater improvement in the PaCO2 values and the tidal volume after the SIMV + PEEP with superimposed IPV than that of with increased PEEP. These results suggest that the beneficial effects of IPV on gas exchange are not caused simply by the elevated airway pressure, but they are mediated by the percussion effect.
