Abstract
The literature and the clinical experience all demonstrate that manual hyperinflation (MH) in patients receiving mechanical ventilation may improve sputum clearance and ventilation. The purpose of this study was to examine the effectiveness of MH in patients with lung atelectasis associated with ventilation support. Twenty-eight patients with lung atelectasis associated with ventilation support, and stable vital signs were randomized into either an experimental group (n=14), or a control group (n=14) in the pulmonary intensive care unit of a Medical Center in northern Taiwan. The MH technique was carried out at a rate of 8∼13 breaths per minute for a period of 20 minutes each session, 3 times per day until weaned from the ventilator. The control group received standard prescribed mechanical ventilation without supplemental MH. Sputum contents (wet/dry weight ratio, viscosity), respiratory system capacity (spontaneous tidal volume (VT), maximal (PI-max), index of rapid shallow breathing (f/VT), dynamic lung compliance, chest x-ray signs and oxygenation ratio (PaO2/FiO2) were all measured just prior to the MH on Day 0 as baseline, and then each day for the next three days. The results showed significant improvements in the scores of the experimental group compared to those of the control group for sputum viscosity (p=0.011) and the index of rapid shallow breathing (p=0.006) after adjusting for covariates. Other outcome variables did not differ significantly between the experimental group and the control group. MH performed in patients with atelectasis associated with ventilation support significantly improved alveolar recruitment.
- © 2011 ERS