Express Healthcare

The Vest: Useful tool for effective CPT in ICU

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All tertiary care intensive care units have large number of patients with respiratory problems, either primary or secondary. Chest physiotherapy (CPT) plays a vital role in the management of these patients. However, CPT in ICU patients is challenging. For patients with altered sensorium and receiving mechanical ventilation, the respiratory therapist (RRT) face challenges in delivering an effective CPT. Postural drainage of secretions may not be possible in all ICU patients.

The Vest, from Hill-Rom, is useful in these kinds of patients where effective chest physiotherapy cannot be given by routine manual methods. The Vest delivers high frequency chest wall oscillation (HFCWO) therapy. It consists of an inflatable jacket/wrap (garment) which is connected to an air pulse generator through tubes. This air generator causes rapid inflation and deflation of the garment, compressing and releasing the chest wall. This action creates an oscillating airflow (we call them ‘mini coughs’). These mini coughs help to dislodge the secretions from the bronchial walls and also help in moving the secretion from the peripheral airways to the central airway.

The Vest provides a safe and effective alternative to the traditional methods of airway clearance. It is a caregiver independent form of CPT. We, at Deenanath Mangeshkar Hospital, has been using The Vest in our ICU for almost a year. The Vest can be used on patients with bronchectasis, cystic fibrosis, neuromuscular disorders and several other conditions requiring airway clearance. It is effective in inpatient, outpatient as well as homecare settings.

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