Thoracic Block Technique Associated with Positive End-Expiratory Pressure in Reversing Atelectasis

Pereira, Luciana Carnevalli; Netto, Ana Paula de Souza; Silva, Fernanda Cordeiro da; Pereira, Silvana Alves; Moran, Cristiane Aparecida

doi:10.1155/2015/490326

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…Also the finding of this study coincided with result in study by Pereira et al (6) who studied the effect of thoracic block technique on atelectasis, in their study they applied this technique in form of two session daily each session last 20 minutes for ten days associated with using CPAP, they showed total reversion of atelectasis without showing desaturation or transient bradycardia.…”

Section: Discussionsupporting

confidence: 89%

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Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Ashary¹,

Hazem²,

Ibrahim³

2022

The Egyptian Journal of Hospital Medicine

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Background: Atelectasis is described as lung collapse that affects one or more regions of the lung. It is characterized by reducing lung volumes, altering the ventilation/perfusion ratio, and being one of the causes of delaying the weaning from mechanical ventilation. The aim of the present study was to investigate the effect of thoracic block technique on atelectasis in children on mechanical ventilation. Patients and methods: A total of 44 children with unilateral atelectasis on mechanical ventilation, from both gender and their ages ranged from 6 months to 4 years, were recruited from intensive care unit (ICU), Abo-Elreesh Hospital, Cairo University. Patients were randomly assigned into two groups; Group A included 22 children who received a designed chest physical therapy program, and Group B included 22 children who received a designed chest physical therapy program and thoracic block technique. Results: A significant increase in the percentage of totally improved lobes of lung in chest X-ray in both groups; the increase was significantly higher in patients who received a designed chest physical therapy program and thoracic block technique than patients who only received a designed chest physical therapy program (P=0.04). There was no significant difference in oxygen saturation index between groups post treatment (P=0.38). Conclusion:Applying thoracic block technique on mechanically ventilated children with atelectasis can produce a significant increase in the percentage of totally improved lobes of lung.

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Section: Discussionsupporting

confidence: 89%

“…The goal of the thoracic block technique with invasive or non-invasive mechanical ventilation is to achieve collapsed alveoli aeration by changing the flow and acting on the airway driving without reaching the lung paranchyma (6) .…”

Section: Introductionmentioning

confidence: 99%

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Ashary¹,

Hazem²,

Ibrahim³

2022

The Egyptian Journal of Hospital Medicine

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“…Manual compression was performed on the upper and lower regions of one thorax of each participant, and it was continuously maintained for five minutes. Then, the manoeuvre was performed on the other hemithorax [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…Other techniques for lung expansion induce a reduction in pleural pressure. Passive manual manoeuvres are among these strategies and include compression-decompression [12][13][14][15][16][17] and chest block techniques [18,19]. Manual manoeuvres are commonly used in clinical practice in countries with few financial and instrumental resources [20].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial

da Silva,

Oliveira,

Cabral

et al. 2023

PLoS ONE

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Pulmonary expansion manoeuvres are therapeutic techniques used to prevent and reverse atelectasis; however, no randomized controlled trials have provided evidence supporting the use of this intervention among individuals on mechanical ventilation. Objective: To evaluate the effects of chest compression-decompression and chest block manoeuvres compared to usual care among patients on mechanical ventilation. Methods: The current study was a randomized clinical trial of adult subjects on mechanical ventilation for 12 to 48 hours. The control group received usual care (passive or active mobilization, manoeuvres for airway clearance and tracheal aspiration). The intervention group received usual care plus two lung expansion manoeuvres, i.e., chest decompression and chest block, while remaining on mechanical ventilation. Assessments were performed before and after usual care, immediately after the intervention and 30 minutes after the intervention. The primary outcome was static compliance. The secondary outcomes were the incidence of atelectasis, dynamic compliance, airway resistance, driving pressure, oxygenation, duration of mechanical ventilation, extubation success, length of hospital and ICU stay, and mortality. Results: Fifty-one participants (67±15 years old, 53% men, 26 in the control group and 25 in the intervention group) were evaluated. No differences in static compliance were observed between groups (intervention minus control) before and after expansion manoeuvres [3.64 ml/cmH2O (95% CI: -0.36–7.65, p = 0.074)]. Peripheral oxygen saturation differed between groups before and after expansion manoeuvres, with more favourable outcome observed in the control group [-1.04% (95% CI: -1.94 –-0.14), p = 0.027]. No differences were found in other outcomes. Conclusion: Chest compression-decompression and chest block manoeuvres did not improve ventilatory mechanics, the incidence of atelectasis, oxygenation, the duration of mechanical ventilation, the length of stay in the ICU and hospital, or mortality in individuals on mechanical ventilation. The findings of this study can be valuable for guiding evidence-based clinical practice and developing a therapeutic approach that provides real benefits for this population.

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“…Dentre as outras técnicas de fisioterapia respiratória vistas nos estudos, destaca-se a técnica inspiratória para reversão da atelectasia (TILA), sendo uma técnica bastante eficaz para reversão de atelectasia, porém só há dois estudos sobre ela e há necessidade de maiores investigações principalmente com maior rigor metodológico [15,35].…”

Section: Técnica De Expiração Forçada (Tef)unclassified

Evidência científica das técnicas atuais e convencionais de fisioterapia respiratória em pediatria

Gomes

2016

Fisioter Bras

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ResumoObjetivo: Revisar na literatura os ensaios clínicos realizados em pediatria envolvendo técnicas de fisioterapia respiratória convencional e atual. Material e métodos: Três bases de dados diferentes foram usadas (Scielo, Pedro e Pubmed). A busca incluiu termos em inglês e português, selecionando estudos que utilizavam técnicas de fisioterapia respiratória atual ou convencional em pacientes com idades entre 0 e 18 anos na presença de alguma doença respiratória. Resultados: Dos 41 artigos encontrados na literatura, 11 foram excluídos baseados em seus resumos e 15 foram retirados do estudo por não preencherem os critérios de inclusão, restando no estudo apenas 15 artigos. Conclusão: Os resultados dos estudos apresentam-se bem controversos: alguns evidenciando os benefícios da fisioterapia respiratória em algumas variáveis clínicas e outros relatando que a mesma não altera sobre o desfecho clínico dos pacientes, sendo necessária a realização de mais estudos nesta área.Palavras-chave: modalidade de fisioterapia, pediatria, respiração. Revisão AbstractObjective: To review the literature on pediatric clinical trials involving conventional and current techniques of respiratory therapy. Material and methods: Three different databases were used (Scielo, Pedro and Pubmed). The search included key-words in English and Portuguese, selecting studies that used current or conventional techniques in patients aged 0-18 years with some respiratory disease. Results: Eleven out of 41 studies found in the literature were excluded based on their abstracts and 15 were withdrawn from the study because they did not meet the inclusion criteria, remaining only 15. Conclusion: The results of the studies are controversial: some authors report the evidence of benefits of respiratory therapy in some clinical variables and others report that it does not change clinical outcome of patients, which indicates that more studies in this area need to be carried out.

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Thoracic Block Technique Associated with Positive End-Expiratory Pressure in Reversing Atelectasis

Cited by 4 publications

References 15 publications

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial

Evidência científica das técnicas atuais e convencionais de fisioterapia respiratória em pediatria

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Thoracic Block Technique Associated with Positive End-Expiratory Pressure in Reversing Atelectasis

Cited by 4 publications

References 15 publications

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial

Evidência cientí­fica das técnicas atuais e convencionais de fisioterapia respiratória em pediatria

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Evidência científica das técnicas atuais e convencionais de fisioterapia respiratória em pediatria