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Influence of intrapulmonary percussive ventilation in upright position on gastro-oesophageal reflux in infants

F Van Ginderdeuren1,2, E Kerckhofs3, M Deneyer4

  • 1Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. filip.vanginderdeuren@telenet.be.

Pediatric Pulmonology
|February 27, 2016
PubMed

Insights

Intrapulmonary percussive ventilation (IPV) in infants significantly reduces gastro-oesophageal reflux (GOR) episodes, particularly in those with pathological reflux. This physiotherapy method does not worsen GOR in any infant group studied.

Area of Science:

  • Pediatric Pulmonology
  • Gastroenterology
  • Respiratory Therapy

Background:

  • Gastro-oesophageal reflux (GOR) is common in infants, potentially leading to complications.
  • Physiotherapy interventions are explored to manage infant GOR.
  • Intrapulmonary percussive ventilation (IPV) is a respiratory technique with potential effects on GOR.

Purpose of the Study:

  • To evaluate the impact of intrapulmonary percussive ventilation in an upright position (IPVR) on gastro-oesophageal reflux (GOR) in infants under one year of age.
  • To determine if IPVR influences the frequency of reflux episodes (RE) in infants, especially those with diagnosed pathological GOR.
  • To assess the safety of IPVR by examining its effect on GOR in infants without pathological reflux.

Main Methods:

  • A controlled trial with an intra-subject design was conducted.
  • Infants underwent 24-hour multichannel intraluminal impedance pH (pH-MII) monitoring.
  • A 20-minute session of IPVR was administered 2 hours post-feeding, with reflux episodes compared to a baseline period.

Main Results:

  • Fifty infants (median age 133 days) were studied; 21 had pathological GOR.
  • Overall, IPVR significantly decreased the number of reflux episodes (RE) compared to baseline (0 vs. 0.71 RE/20 min, P=0.003).
  • Infants with pathological GOR showed a significant reduction in RE during IPVR (0 vs. 1.17 RE/20 min, P=0.03), while those with normal reflux showed no significant change.

Conclusions:

  • Intrapulmonary percussive ventilation in an upright position (IPVR) effectively reduces gastro-oesophageal reflux episodes in infants with pathological GOR.
  • IPVR is safe and does not induce or aggravate GOR in infants, regardless of their reflux status.
  • This physiotherapy technique offers a potential non-pharmacological approach for managing GOR in infants.
Abstract

Keywords:
airway clearance techniqueschildrenphysical therapyrespiratory physiotherapy

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