Whitman J, Van Beusekom R, Olson S, Worm M, Indihar F
Healtheast Bethesda Lutheran Hospital, St Paul, MN 55102.
Respir Care. 1993 Oct;38(10):1081-7.
A high-frequency chest compression (HFCC) device called the ThAIRapy System has been developed to provide secretion clearance therapy. We evaluated the safety, efficacy, and utility of the device in long-term mechanically ventilated patients. DESCRIPTION OF DEVICE: The primary components of the device are an air-pulse generator and an inflatable vest. Small gas volumes are alternately injected into and withdrawn from the vest by the air-pulse generator at a fast rate, creating an oscillatory or vibratory motion. The pulses cause the vest to inflate and deflate against the thorax of the patient.
We evaluated HFCC by comparing it to percussion and postural drainage therapy (P&PD); sputum production, patient comfort (PC), pulse-oximetry saturation (SpO2), heart rate (HR), and blood pressure (BP) data were collected and compared between the 2 methods. We monitored the reliability of the device and distributed a survey questionnaire to the entire respiratory therapy staff to assess utility.
Nine patients completed the safety and efficacy portion of our evaluation. No significant difference was found between P&PD and HFCC in the wet weight of collected sputum, the mean change-in-percent of SpO2 or the mean percent change from baseline in HR, BP, or PC. All therapists believed that the ThAIRapy System was easy to learn, and 70% considered it an acceptable alternative to P&PD. Of the staff members surveyed, 80% believed that use of the HFCC device resulted in time savings in all or most cases. There were no equipment malfunctions in 225 hours of use.
Compared to P&PD, HFCC via the ThAIRapy System may be equally efficacious in promoting secretion clearance in long-term mechanically ventilated patients. HFCC is neither more nor less safe for patients than is P&PD using SpO2, HR, BP, and PC as outcome variables. Most of our respiratory therapists perceived HFCC as an acceptable alternative to P&PD.
已研发出一种名为ThAIRapy系统的高频胸部按压（HFCC）设备，用于提供分泌物清除治疗。我们评估了该设备在长期机械通气患者中的安全性、有效性和实用性。
该设备的主要组件是一个空气脉冲发生器和一件可充气背心。空气脉冲发生器以快速速率将少量气体交替注入背心并从背心抽出，产生振荡或振动运动。这些脉冲使背心紧贴患者胸部充气和放气。
我们通过将HFCC与叩击和体位引流治疗（P&PD）进行比较来评估HFCC；收集痰液产生量、患者舒适度（PC）、脉搏血氧饱和度（SpO2）、心率（HR）和血压（BP）数据，并在两种方法之间进行比较。我们监测了设备的可靠性，并向全体呼吸治疗人员发放了调查问卷以评估实用性。
9名患者完成了我们评估的安全性和有效性部分。在收集痰液的湿重、SpO2平均变化百分比或HR、BP或PC相对于基线的平均变化百分比方面，P&PD和HFCC之间未发现显著差异。所有治疗师都认为ThAIRapy系统易于学习，70%的人认为它是P&PD的可接受替代方法。在接受调查的工作人员中，80%的人认为在所有或大多数情况下使用HFCC设备节省了时间。在225小时的使用中没有设备故障。
与P&PD相比，通过ThAIRapy系统进行的HFCC在促进长期机械通气患者的分泌物清除方面可能同样有效。以SpO2、HR、BP和PC作为结果变量，HFCC对患者的安全性与P&PD相当。我们的大多数呼吸治疗师认为HFCC是P&PD的可接受替代方法。
