Effects of manual chest compression and descompression maneuver on lung volumes, capnography and pulse oximetry in patients receiving mechanical ventilation

Abstract

Effects of manual chest compression and descompression maneuver on lung volumes, capnography and pulse oximetry in patients receiving mechanical ventilation Efeitos da manobra de compressão e descompressão torácica nos volumes pulmonares, capnografia e oximetria de pulso em pacientes submetidos à ventilação mecânica AbstractObjectives: The aims of this study were to evaluate whether there are changes in lung volumes, capnography, pulse oximetry and hemodynamic parameters associated with manual chest compression-decompression maneuver (MCCD) in patients undergoing mechanical ventilation (MV).Method: A prospective study of 65 patients undergoing to MV after 24 hours. All patients received bronchial hygiene maneuvers and after 30 minutes they were submitted to ten repetitions of the MCCD during 10 consecutive respiratory cycles in the right hemithorax and than in the left hemithorax. The data were collected before the application of the maneuver and after 1,5,10,15,20,25, 30, 35 Keywords: manual chest maneuver; mechanical ventilation; atelectasis; physical therapy. ResumoObjetivos: Avaliar a presença de alterações nos volumes pulmonares, oximetria de pulso, capnografia e alterações hemodinâmicas associadas à intervenção da manobra de compressão e descompressão torácica (MCDT) nos pacientes submetidos à ventilação mecânica (VM). Método:Tratou-se de um estudo prospectivo em que foram incluídos 65 pacientes em VM há mais de 24 horas. O protocolo consistiu na aplicação de manobras de higiene brônquica e, após 30 minutos, os pacientes eram submetidos a dez repetições da MCDT em dez respirações consecutivas no hemitórax direito e, posteriormente, no hemitórax esquerdo, coletando os dados antes e após a aplicação da manobra nos tempos 1,5,10,15,20,25, 30, 35 ,8; p=0,99). As variáveis foram expressas em média e desviopadrão. Conclusão: A MCDT possibilita a otimização dos volumes pulmonares, da oximetria de pulso e a redução do CO 2 expirado sem promover alterações hemodinâmicas significantes nos pacientes submetidos à ventilação mecânica.Registro de ensaio clínico RBR-268hqh.

Assessment of the Effects of Manual Chest Compression Technique on Atelectasis in Infants: A Randomized Clinical Trial

“…The lung re-expansion is able to prevent or reverse ventilatory inequality situations, through the variation of intrathoracic pressures or by proper positioning, assisting in the optimization of pulmonary perfusion. The maneuver of thoracic blockade or MCC is indicated in patients that are less cooperative [7]- [9], but its effects are questionable and poorly studied.…”

“…Della Via et al [9] applied the MCC associated with decompression in adults under MV and observed positive effects in the minute volume, tidal volume and oxygenation proving that the improvement attributed to the technique occurs in patients with positive pressure on airways.…”

Impacto de dois métodos de reexpansão pulmonar em pacientes submetidos a cirurgia bariátrica por videolaparoscopia

“…The positive response of obese patients to CCDM use in the postoperative period (six hours after surgery) likely derived from hypoventilation correction. According to Via et al [7], CCDM reduced the incidence of pulmonary complications such as hypoventilation and atelectasis, as well as the development of acute hypoxemia after surgery due to pulmonary ventilation restoration, which improved oxygenation and decreased CO2 levels. Unoki et al [23] applied CCDM to 31 mechanically ventilated patients and found Fisioterapia Brasil 2021;22(1):37-48 that this maneuver enabled bronchial hygiene by increasing expiratory time and peak expiratory flow.…”

“…Patients assessed in the current study did not present changes in bronchial hygiene needs. Via et al [7] performed bronchial hygiene before CCDM application in all patients; however, Unoki et al [23] performed CCDM without previous bronchial hygiene, which may have reinforced its effects on bronchial hygiene, but not on pulmonary expansion.…”

“…According to Pazzianotto-Forti et al [6], preoperative and postoperative respiratory physical therapy is beneficial and essential to help morbid obesity patients maintaining their pulmonary function and to prevent pulmonary complications. Manual chest compression and decompression maneuver (CCDM) is a physical therapy technique adopted to help opening collapsed alveoli by both increasing the transpulmonary pressure gradient and guiding air flow and volume to the airways to increase oxygenation [7].…”