Manual hyperinflation and the role of physical therapy in intensive care and emergency units

Cruz, Rafael Viní­cius Santos; Andrade, Fabiana do Socorro da Silva Dias de; Menezes, Pollyanna Dórea Gonzaga de; Gonçalves, Bruno Oliveira; Almeida, Robson da Silva; Santos, Anderson Reis

doi:10.1590/1980-5918.030.s01.ao23

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…In Paulus et al's review [26] there are no indications for the use of this technique in unstable, intubated and mechanically ventilated patients. Manual hyperinflation does not appear to be associated with a reduction in the duration of mechanical ventilation, permanence in the ICU and prevention of ventilator-associated pneumonia [26], and further studies are necessary to investigate the use of MHI by physical therapists for better understanding benefits and intrinsic risks [27]. Very interesting is a review investigating the role of physiotherapy in reducing the symptoms of post-intensive care syndrome (PICS) [28].…”

Section: Manual Hyperinflation (Mhi)mentioning

confidence: 99%

Rehabilitation Needs of Patients with Covid-19 in Acute Phase

Garofano

Ascoli

Palumbo

et al. 2020

RRHOAJ

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is a viral infection caused by 2], that primarily affects the lower respiratory tract and causes a number of symptoms described as flu-like, including fever, cough, shortness of breath, myalgia and fatigue [1]; in severe cases pneumonia, Acute Respiratory Distress Syndrome (ARDS), sepsis and septic shock can occur, up to the death of the patients [3]. Treatment of the disease generally consists of managing clinical symptoms and in case of more severe complications, such as ARDS, which develops in more than 40% of hospitalized patients, 10% require transfer to ICU (Intensive Care Unit) [4]. Since this type of infection is extremely recent, there are only few studies on the rehabilitation of patients with COVID-19, and among them we mention recommendations [5] published in China, a very recent international document [6], and an Italian position paper [7]. This article is a narrative literature review and the papers were identified via a search of PubMed, Scopus and Pedro

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Section: Manual Hyperinflation (Mhi)mentioning

confidence: 99%

Rehabilitation Needs of Patients with Covid-19 in Acute Phase

Garofano

Ascoli

Palumbo

et al. 2020

RRHOAJ

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“…Impaired clearance of the airway is one of the bigger reason of acute respiratory failure and admission in intensive care unit. In intensive care unit usually manual methods are used to facilitate airway clearance and some of them are confirmed as effective (1). Mucous plugs those are retained secretions in tracheobronchial tree are often observed in patients who are mechanically ventilated due to depressed mucociliary clearance, cough reflex and more production of sputum (2).…”

Section: Introductionmentioning

confidence: 99%

Role of N-Acetylcysteine in Clearance of Secretions in Mechanical Ventilated Patients

2019

JMPB

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Objective: to determine the role of nebulized N-acetylcysteine in mechanical ventilation in clearing the airway of these patients. Study Design: A Randomized Control Trial. Place and Duration .Methods: In this project total 50 patients were enrolled by consecutive sampling who remained on mechanical ventilation for more than 24 hours and were between age 15 to 80 years old. Written consent of this project was taken from relative of each patient. These patients were divided into two groups by lottery method into case and control. The case group received 2 ml of NAC 20% with 8 ml normal saline 3 times a day for 1 day. The control group only received 10 ml normal saline via their nebulizers 3 times a day at 8 AM, 2 PM, and 9 PM. Data was collected and was analyzed. SPSS 22 was used for this purpose. All numerical variables of this research such as mean FiO2, mean peak and plateau pressure of airway, mean blood pressure, mean age and importantly mean density of secretions were calculated. In these values t test was applied and p value was calculated. If it was less than .005, then it was considered significant. Similarly, qualitative data such as type of disease were calculated in percentage and chi square test was used to check the significance. Results: The mean O2 saturation of baseline, 12 hours and 24 hours of the controls was 93.84±2.28, 94.27±2.33 and 94.08±1.81 respectively. The mean peak airway pressure of baseline, 12 hours and 24 hours of the controls was 23.16±3.49, 25.38±8.86 and 24.01±4.91 respectively. The mean plateau airway pressure of baseline, 12 hours and 24 hours of the controls was 19.04±7.79, 21.37±4.86 and 21.85±8.93 respectively. The mean secretion density of baseline, 12 hours and 24 hours of the controls was 1.04±0.024, 1.05±0.03 and 1.03±0.002 respectively. While, the mean O2 saturation of baseline, 12 hours and 24 hours of the cases was 93.08±2.37, 94.61±2.56 and 94.11±2.34 respectively. The mean peak airway pressure of baseline, 12 hours and 24 hours of the cases was 26.58±5.81, 23.81±8.28 and 24.34±6.15 respectively. The mean plateau airway pressure of baseline, 12 hours and 24 hours of the cases was 21.88±78.01, 24.88±6.67 and 23.51±7.55 respectively. The mean secretion density of baseline, 12 hours and 24 hours of the cases was 1.01±0.021, 1.08±0.022 and 1.008±0.0195 respectively. The differences were statistically insignificant. P-value ≤ 0.05 is considered as significant. Conclusion: It is concluded from our observations that use of N-acetylcysteine in patients on mechanical ventilation is very effective in clearance of secretion and to maintain airway clear.

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The Effects of Manual Lung Hyperinflation on Pulmonary Function after Weaning from Mechanical Ventilation among Patients with Abdominal Surgeries: Randomized Clinical Trial

et al. 2021

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Introduction: After abdominal surgery, the patients who are separated from mechanical ventilation and provided with oxygen therapy via a T-piece are at risk for respiratory complications. Therefore, they need additional respiratory support. This study aimed to evaluate the effects of manual hyperinflation (MHI) on pulmonary function after weaning. Methods: This randomized clinical trial included 40 patients who had undergone abdominal surgery and were receiving oxygen via a T-piece. Patients were selected from the intensive care units (ICU) of two hospitals in Mashhad, Iran. The subjects were randomly allocated to intervention (MHI) and control groups. Patients in the MHI group were provided with three 20-minute MHI rounds using the Mapleson C, while the control group received routine cares. Tidal volume (Vt), Rapid Shallow Breathing Index (RSBI), and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio) were measured before the intervention, as well as 5 and 20 minutes after the intervention. Atelectasis prevalence was assessed before and 24 hours after the intervention. Data were analysed by SPSS software version 13. Results: At baseline, there were no significant differences between the groups regarding Vt, RSBI, P/F ratio, and atelectasis rate. No significant difference was also found between the groups regarding atelectasis rate 24 hours after the intervention. However, at both posttests, Vt, RSBI, and P/F ratio in the MHI group were significantly better than the control group. Conclusion: In patients with artificial airway and spontaneous breathing, MHI improves pulmonary function.

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Manual hyperinflation and the role of physical therapy in intensive care and emergency units

Cited by 3 publications

References 25 publications

Rehabilitation Needs of Patients with Covid-19 in Acute Phase

Rehabilitation Needs of Patients with Covid-19 in Acute Phase

Role of N-Acetylcysteine in Clearance of Secretions in Mechanical Ventilated Patients

The Effects of Manual Lung Hyperinflation on Pulmonary Function after Weaning from Mechanical Ventilation among Patients with Abdominal Surgeries: Randomized Clinical Trial

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