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Manual hyperinflation — Effects on respiratory parameters
Author(s) -
Patman Shane,
Jenkins Sue,
Stiller Kathy
Publication year - 2000
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.196
Subject(s) - medicine , atelectasis , oxygenation , anesthesia , fraction of inspired oxygen , chest physiotherapy , respiratory physiology , randomized controlled trial , respiratory system , oxygen tension , mechanical ventilation , lung , surgery , oxygen , chemistry , organic chemistry
Background and Purpose Manual hyperinflation (MH) of the lungs is commonly used by physiotherapists in the treatment of intubated mechanically ventilated patients with the aim of increasing alveolar oxygenation, reversing atelectasis or mobilizing pulmonary secretions. However, the efficacy of MH, used in isolation, has not been clearly established. Method This randomized, controlled trial investigated the effects of MH on lung compliance (C L ), the arterial oxygen to fraction of inspired oxygen ratio (P a O 2 :FIO 2 ) and the alveolar–arterial oxygen tension difference (A–a)PO 2 in 100 medically stable, mechanically ventilated subjects who had undergone coronary artery surgery (CAS). Post‐CAS subjects were used for this study as they constitute a large, homogeneous and accessible group. Subjects were randomized to either a control group (non‐MH group) or to a treatment group (MH group) which received MH within four hours of surgery. Results After four minutes of MH there were significant improvements in C L , P a O 2 :FIO 2 and (A–a)PO 2 with values remaining above baseline measures at 60 min post‐intervention. The mean improvement in C L was 6 ml/cmH 2 O (approximately 15%), 56 mmHg for P a O 2 :FIO 2 (approximately 17%) and 29 mmHg for (A–a)PO 2 (approximately 17%) immediately post‐intervention. No significant changes in mean C L , P a O 2 :FIO 2 or (A–a)PO 2 were seen in the non‐MH group. Conclusions MH performed in the stable ventilated patient significantly increased C L and P a O 2 :FIO 2 and decreased (A–a)PO 2 , but the clinical significance of this improvement is unclear. Further investigations are required to validate the findings of this study as well as to determine the therapeutic value of MH on patient outcome. Copyright © 2000 Whurr Publishers Ltd.