The Effects of Mask Selection and Securement on Percussive Therapy

Abstract

Background:

IPV is used by some as a treatment option for atelectasis and mucus clearance in patients. The goal of this study is to assess different mask types, securement methods, and their impacts on pressure amplitudes (∆P) and mean airway pressure (MAP). Given that the device has a wide range of frequencies, we will assess the low and high frequency to create an impact range. Our hypothesis is that the ∆P and MAP of the percussive device is not dependent on the type of mask or securement method that is utilized.

Methods:

The IPV from PercussionAire (Sand Point, ID) was set to Demand CPAP/PEEP off, Insp. Flow to max, and Insp. time to neutral. The phasitron was then connected to an IngMar Medical (Pittsburgh, PA) ASL 5000 Active Servo Lung and set to passive lung settings and a COPD profile (CS 55 mL/cm H₂O, RAW 22 cm H₂O/L/s). Measurements of average PIP, PEEP, and MAP were recorded for two frequencies (high and low). For the low frequency run, the IPV was set to the lowest frequency, placed on the ASL for 1 min, measurements recorded and repeated 4 times. IPV then changed to highest frequency and measurements recorded 5 times. The different user interfaces were the BiPAP PerformaTrak Full Mask (Respironics, Murrysville, PA) using provided straps, BiPAP mask held on Mannequin head by researcher to assure no leak, Ambu Spur II (Ambu, Glen Burnie, MD) mask held on head. The three user interfaces were tested on both the high and low frequencies.

Results:

After averaging PIP and PEEP for all five trials, the ∆P was then calculated for each of the user interfaces at low and high frequencies. The ∆P on low frequency using the strapped BiPAP was 10.48, held BiPAP 13.2, and Ambu masks 9.6 cm H₂O respectively. ∆P on high frequency using the strapped BiPAP was 8.62, held BiPAP 9.41, and Ambu masks 8.65 cm H₂O respectively. MAP on low frequency using the strapped BiPAP was 4.14, held BiPAP 5.63, and Ambu masks 4.08 cm H₂O respectively. MAP on high frequency using the strapped BiPAP was 3.99, held BiPAP 4.39, and Ambu masks 4.22 cm H₂O respectively.

Conclusions:

Of the mask selection and securements studied, the held BiPAP mask delivered the greatest average ∆P and MAPs to the carina in both low and high frequencies. There was a difference in mask selection as opposed to our original hypothesis; however, further research is needed to determine clinical significance of these differences and their impacts on atelectasis and secretion removal.