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Positive expiratory pressure device acceptance by hospitalized children with sickle cell disease is comparable to

Lewis L Hsu1, Brenda K Batts, Joseph L Rau

  • 1Pediatric Hematology, St Christopher's Hospital for Children, Drexel University College of Medicine, Erie Avenue at Front Street, Philadelphia PA 19134, USA. lhsu@mail.nih.gov

Respiratory Care
|May 6, 2005
PubMed

Insights

Intermittent positive expiratory pressure (PEP) therapy may be a viable alternative to incentive spirometry (IS) for preventing acute chest syndrome (ACS) in children with sickle cell disease, showing similar patient satisfaction and hospital stay durations.

Area of Science:

  • Pediatric Pulmonology
  • Hematology
  • Critical Care Medicine

Background:

  • Acute chest syndrome (ACS) is a severe complication of sickle cell disease (SCD) associated with high morbidity and mortality.
  • Incentive spirometry (IS) is recommended for ACS prevention in SCD patients but can be challenging for children.
  • Intermittent positive expiratory pressure (PEP) therapy presents a potentially more accessible alternative for pediatric SCD patients.

Purpose of the Study:

  • To compare the efficacy of PEP therapy versus conventional IS in hospitalized children with SCD.
  • To evaluate patient satisfaction, length of hospital stay, and progression to ACS between PEP and IS groups.
  • To assess the feasibility of PEP as a preventive respiratory therapy in pediatric SCD management.

Main Methods:

  • A pilot randomized trial involving 20 children hospitalized for sickle cell pain.
  • Participants were randomly assigned to receive either PEP therapy (n=11) or IS (n=9).
  • Respiratory therapies were administered hourly by a therapist while patients were awake.

Main Results:

  • Patient satisfaction was high and comparable between the PEP and IS groups (4.5 vs 4.4, p=0.81).
  • Hospital length of stay was similar for both groups (5 days vs 4.3 days, p=0.56).
  • No participants in either group progressed to develop ACS.

Conclusions:

  • Preliminary findings indicate no significant difference in patient satisfaction or hospital stay between PEP and IS therapies.
  • PEP therapy shows promise as an alternative to IS for preventing ACS in at-risk pediatric SCD patients.
  • Further research is warranted to explore intermittent PEP therapy's role in preventive respiratory care for SCD.
Abstract

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