What is the most appropriate alteration in therapy for a patient with PVCs during postural drainage?

For a patient who is experiencing premature ventricular contractions (PVCs) during postural drainage, the most appropriate alteration in therapy would be to switch to high-frequency oscillatory chest wall compression. This approach is less likely to provoke arrhythmias than traditional postural drainage techniques, which can sometimes exacerbate cardiac irregularities due to changes in thoracic pressure or body position.

High-frequency oscillatory devices use rapid oscillations to help mobilize secretions without the need for deep percussion or the change in body positions that might stimulate further PVCs. This method reduces the risk of patient discomfort and potential cardiac complications associated with increased intracranial and intrathoracic pressure that can occur with other techniques.

Maintaining optimal patient safety and comfort while effectively managing respiratory therapy is paramount, and high-frequency oscillation can provide that balance. If other methods were considered, they might not adequately address the potential irritants associated with PVCs, which is why choosing high-frequency oscillatory therapy is particularly advantageous in this scenario.