Intrapulmonary percussive ventilation improves the outcomes of helmet ventilation.

Questions: In adults with an acute exacerbation of chronic obstructive pulmonary disease (COPD) receiving non-invasive positive pressure ventilation (NIV), is intrapulmonary percussive ventilation (IPV) feasible? Does IPV improve outcomes compared to manual airway clearance techniques? Design: Randomised, controlled trial with concealed allocation. Setting: Intensive care unit of a tertiary hospital in Italy. Participants: Forty adults with an acute exacerbation of COPD ventilated with NIV via a helmet interface. Inclusion criteria included tachypnoea and respiratory acidosis. Interventions: Participants were randomly allocated on admission to the unit to receive twice-daily IPV or manual airway clearance techniques, commencing on the second day of NIV. Periods of 3–4 hours of ventilation were alternated with 2–3 hours of spontaneous breathing with controlled oxygen therapy. The IPV consisted of breathing through a mouthpiece that delivered Intrapulmonary percussive ventilation improves the outcomes of helmet ventilation