Introduction: Intrapulmonary percussive ventilation (IPV) is used in various clinical settings to treat pulmonary atelectasis, excessive airway secretion and poor gas exchange. Despite its wide use, there is a lack of clinical guidance on IPV application and dosage, resulting in inconsistencies in clinical practice. This review aimed to summarise the clinical application methods and dosage of IPV to guide clinicians.

Methods: A systematic search was conducted to retrieve studies that used IPV in ICU, inpatient (non-ICU) and outpatient settings. MEDLINE, EMBASE, CINAHL, Scopus and Google scholar were searched from 1979 to 2022. Two reviewers screened the study titles and abstracts. Full-text articles were reviewed for data extraction.

Results: The search yielded 514 studies. After removing duplicates and irrelevant studies, 25 studies with 905 participants met the inclusion criteria. Variations were observed in clinical applications and dosages of IPV across clinical settings. Despite variations, there were some common trends in IPV applications within similar clinical settings. In ICU, IPV was delivered via a facemask or a mechanical ventilator using a frequency of 200 to 300 cycles/minute, with pressure from 10 to 20cm H2O for 10 to 20 minutes twice a day. In the outpatient setting, a frequency of 100 to 360 cycles/minute and pressure of 10-30cm H2O for 15-20 minutes once daily was used.

Conclusion: Due to the observed differences in the treatment regimens, application methods, and dosages of IPV in various clinical conditions and settings, a treatment guideline could not be provided. However, some common practices of IPV application were observed and summarised to guide clinicians.