Ten spontaneously breathing patients with severe chronic obstructive pulmonary disease (COPD) who were hospitalized for acute nonspecific exacerbation underwent chest percussion and vibration in the prone Trendelenburg and supine Trendelenburg positions while undergoing constant oxygen saturation monitoring via ear oximetry. Most patients had an elevated Paco2 and required oxygen to maintain a Pa02 >60 mm Hg, but neither atelectasis nor pneumonia was present. No significant alterations in oxygen saturation were found. Chest physiotherapy as performed in this study on acutely ill patients with severe COPD did not appear to produce dangerous hypoxemia.
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