Comparison of flow rates produced by two frequently used manual hyperinflation circuits: A benchtop study

Jones, Alison; Thomas, Peter J.; Paratz, Jenny Davida

doi:10.1016/j.hrtlng.2009.06.002

Cited by 15 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…32 Although manual hyperinflation may be commonly delivered with short inspiratory times, 6,7,18 there may be additional factors that facilitate mucus movement under these conditions. It is likely that alterations in V T , 32 airway resistance and airway pressure, 17 manual hyperinflation circuit design, [23][24][25][26] and inclusion of an inspiratory hold 17 may also interact with the expiratory flow bias and alter whether the expiratory flow bias thresholds can be exceeded. Furthermore, gravity, 21 mucus layer thickness and consistency, 19 and patient expiratory effort probably interact with the expiratory flow bias generated and impact mucus Values are mean Ϯ SD.…”

Section: Discussionmentioning

confidence: 99%

“…One experienced cardiothoracic physiotherapist performed manual hyperinflation on the bench model until 30 acceptable applications were recorded for all 6 experimental conditions, which were pairwise combinations of inspiratory time (1, 2, or 3 s) and lung compliance settings used in previous bench studies (0.05 L/cm H 2 O to simulate normal lung compliance 11,18,26,30 or 0.02 L/cm H 2 O to simulate lower lung compliance [to mimic lung compliance found in ARDS 26,31 ]). Upper and lower airway resistance were standardized to simulate normal intubated adult airway resistance across all trials.…”

Section: Experimental Designmentioning

confidence: 99%

“…[23][24][25][26] and expiratory release techniques 11,18 By comparison, less attention has been directed to ways in which a slower inspiratory flow can be generated, such as through a prolonged inspiratory time. Furthermore, it appears in practice that the typical inspiratory time taken to deliver a breath during manual hyperinflation may be much shorter than the early recommendations of 3 s. 10 Most studies suggest that 1-2 s of inspiratory time during manual hyperinflation is commonly used, 16,17,27 possibly due to the physiotherapist accommodating to minimize patient…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Inspiratory Time and Lung Compliance on Flow Bias Generated During Manual Hyperinflation: A Bench Study

2015

View full text Add to dashboard Cite

BACKGROUND: Manual hyperinflation can be used to assist mucus clearance in intubated patients. The technique's effectiveness to move mucus is underpinned by its ability to generate flow bias in the direction of expiration, and this must exceed specific thresholds. It is unclear whether the inspiratory times commonly used by physiotherapists generate sufficient expiratory flow bias based on previously published thresholds and whether factors such as lung compliance affect this.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Experimental Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Inspiratory Time and Lung Compliance on Flow Bias Generated During Manual Hyperinflation: A Bench Study

2015

View full text Add to dashboard Cite

show abstract

“…Following the use of various SIB models (for adults), the results showed that this device may not be effective in the removal of secretions depending on the level of positive end-expiratory pressure (PEEP) used, in addition to the presence of significant differences in the PEF and TV promoted by the various models of SIB used. (15,16) Moreover, these differences may represent a negative factor in the case of children, as high TV and pressures are predisposing factors for lung injury (barotrauma, volutrauma, and biotrauma). (17) None of the studies included in the present systematic review analyzed the SIB models used.…”

Section: Discussionmentioning

confidence: 99%

Manual hyperinflation in airway clearance in pediatric patients: a systematic review

Godoy¹,

Zanetti²,

Johnston³

2013

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

ObjectiveTo perform an assessment of the available literature on manual hyperinflation as a respiratory physical therapy technique used in pediatric patients, with the main outcome of achieving airway clearance. MethodsWe reviewed articles included in the Lilacs (Latin American and Caribbean Literature on Health Sciences/Literatura Latino Americana e do Caribe em Ciências da Saúde), Cochrane Library, Medline (via Virtual Health Library and PubMed), SciELO (Scientific Electronic Library), and PEDro (Physiotherapy Evidence Database) databases from 2002 to 2013 using the following search terms: "physiotherapy (techniques)", "respiratory therapy", "intensive care", and "airway clearance". The selected studies were classified according to the level of evidence and grades of recommendation (method of the Oxford Centre for Evidence-Based Medicine) by two examiners, while a third examiner repeated the search and analysis and checked the classification of the articles. ResultsThree articles were included for analysis, comprising 250 children (aged 0 to 16 years). The main diagnoses were acute respiratory failure, recovery following heart congenital disease and upper abdominal surgery, bone marrow transplantation, asthma, tracheal reconstruction, brain injury, airway injury, and heterogeneous lung diseases. The studies were classified as having a level of evidence 2C and grade of recommendation C. ConclusionsManual hyperinflation appeared useful for airway clearance in the investigated population, although the evidence available in the literature remains insufficient. Therefore, controlled randomized studies are needed to establish the safety and efficacy of manual hyperinflation in pediatric patients. However, manual hyperinflation must be performed by trained physical therapists only.

show abstract

“…Physiotherapy procedures provides stability of hemodynamic variables, such as heart rate (HR) [6-9], the functional maintenance of newborn cerebral circulation and maintenance of airways with turbulent flow and minimal secretion, which allow a increased permeability and reduced number of intrinsic airway that contribute to increased airway resistance and decrease in gas changes physiological events [3]. …”

Section: Introductionmentioning

confidence: 99%

Chest associated to motor physiotherapy improves cardiovascular variables in newborns with respiratory distress syndrome

Abreu¹,

Valenti²,

Oliveira³

et al. 2011

Int Arch Med

View full text Add to dashboard Cite

BackgroundWe aimed to evaluate the effects of chest and motor physiotherapy treatment on hemodynamic variables in preterm newborns with respiratory distress syndrome.MethodsWe evaluated heart rate (HR), respiratory rate (RR), systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP), temperature and oxygen saturation (SO2%) in 44 newborns with respiratory distress syndrome. We compared all variables between before physiotherapy treatment vs. after the last physiotherapy treatment. Newborns were treated during 11 days. Variables were measured 2 minutes before and 5 minutes after each physiotherapy treatment. We applied paired Student t test to compare variables between the two periods.ResultsHR (148.5 ± 8.5 bpm vs. 137.1 ± 6.8 bpm - p < 0.001), SAP (72.3 ± 11.3 mmHg vs. 63.6 ± 6.7 mmHg - p = 0.001) and MAP (57.5 ± 12 mmHg vs. 47.7 ± 5.8 mmHg - p = 0.001) were significantly reduced after 11 days of physiotherapy treatment compared to before the first session. There were no significant changes regarding RR, temperature, DAP and SO2%.ConclusionsChest and motor physiotherapy improved cardiovascular parameters in respiratory distress syndrome newborns.

show abstract

Comparison of flow rates produced by two frequently used manual hyperinflation circuits: A benchtop study

Cited by 15 publications

References 17 publications

Effect of Inspiratory Time and Lung Compliance on Flow Bias Generated During Manual Hyperinflation: A Bench Study

Effect of Inspiratory Time and Lung Compliance on Flow Bias Generated During Manual Hyperinflation: A Bench Study

Manual hyperinflation in airway clearance in pediatric patients: a systematic review

Chest associated to motor physiotherapy improves cardiovascular variables in newborns with respiratory distress syndrome

Contact Info

Product

Resources

About