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Pulmonary vest therapy in pediatric long-term care

Audrius V Plioplys1, Shelley Lewis, Irene Kasnicka

  • 1Little Angels Nursing Home, Elgin, Illinois, USA.

Journal of the American Medical Directors Association
|June 17, 2003
PubMed

Insights

High frequency chest wall oscillation with vest therapy (VT) effectively cleared pulmonary secretions and reduced pneumonia incidence in children with quadriplegic cerebral palsy. VT also decreased hospitalizations and, in patients with epilepsy, reduced seizure frequency.

Area of Science:

  • Pediatric Pulmonology
  • Neurology
  • Rehabilitation Medicine

Background:

  • Children with quadriplegic cerebral palsy frequently experience pulmonary infections.
  • Vest therapy (VT) is established for pulmonary clearance in cystic fibrosis.
  • The efficacy of VT in quadriplegic cerebral palsy requires investigation.

Purpose of the Study:

  • To evaluate the effectiveness of vest therapy (VT) for pulmonary clearance in children with quadriplegic cerebral palsy.
  • To assess VT's impact on pulmonary infection rates and hospitalizations.
  • To determine VT's effect on seizure frequency in patients with co-occurring epilepsy.

Main Methods:

  • A cohort of seven individuals with quadriplegic cerebral palsy (ages 7-28) residing in skilled nursing facilities was studied.
  • Clinical data on pulmonary infections and seizures were collected for 12 months pre-VT and 12 months during VT.
  • Five participants had tracheostomies, and three had active seizure disorders.

Main Results:

  • Pneumonia incidence requiring antibiotics decreased by 50% (36 to 18 cases/year).
  • Hospitalizations due to pneumonia reduced from 9 to 3 annually.
  • Effective pulmonary secretion suctioning frequency significantly increased (P < 0.01).
  • In patients with epilepsy, average monthly seizure frequency decreased significantly.

Conclusions:

  • Vest therapy (VT) improves pulmonary secretion clearance and reduces pneumonia incidence and hospitalizations in quadriplegic cerebral palsy.
  • VT also demonstrated a reduction in seizure frequency in patients with epilepsy.
  • VT was well-tolerated, indicating its potential as a safe intervention for this population.
Abstract

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