Poster 1: Pulmonary vest therapy to prevent pneumonias in quadriplegic cerebral palsy

Objectives: To extend our previous observations (J Am Med Directors Assn 2002;3:318-21) on the effectiveness of high-frequency chest wall oscillation vest therapy, with the Advanced Respiratory vest, for preventing pneumonias. Design: Quantitative research using before-during treatment data. Setting: 2 pediatric skilled nursing facilities for children with severe cerebral palsy (CP). Participants: 11 subjects (6 men, 5 women), with severely quadriplegic CP and frequent pulmonary infections, were identified (age range, 1-28y; median, 17y). All were fed by gastrostomy tube; 9 had a tracheostomy; and 6 had epilepsy. Interventions: Not applicable. Main Outcome Measures: Data were collected for the 12 months prior to initiation of vest therapy and for the 12 months of vest therapy. Results: The number of pneumonias decreased from 52 to 27 per year (P<.05). The number of hospitalizations due to pneumonia decreased from 13 to 3 (P<.05). The frequency of effective suctioning of pulmonary secretions was significantly increased (P<.001) and the frequency of seizures decreased (P<.05). Conclusion: Vest therapy resulted in a statistically significant reduction in the incidences of pneumonias, number of hospitalizations for pneumonia, and seizure frequency. Vest therapy was tolerated well, without side effects.