Open AccessImmediate effects of manual hyperinflation on cardiorespiratory function and sputum clearance in mechanically ventilated pediatric patients: A randomized crossover trial
Author(s) -
Tawatchai Luadsri,
Jaturon Boonpitak,
Kultida Pongdech-Udom,
Patnuch Sukpom,
Weerapong Chidnok
Publication year - 2021
Publication title -
hong kong physiotherapy journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.343
H-Index - 15
eISSN - 1876-441X
pISSN - 1013-7025
DOI - 10.1142/s1013702522500020
Subject(s) - medicine , cardiorespiratory fitness , pediatric intensive care unit , crossover study , anesthesia , mechanical ventilation , heart rate , respiratory rate , tidal volume , chest physiotherapy , ventilation (architecture) , mean airway pressure , peak inspiratory pressure , blood pressure , sputum , pulmonary compliance , randomized controlled trial , respiratory system , intensive care medicine , placebo , mechanical engineering , tuberculosis , alternative medicine , pathology , engineering
Background: In developing countries, lower respiratory tract infection is a major cause of death in children, with severely ill patients being admitted to the critical-care unit. While physical therapists commonly use the manual hyperinflation (MHI) technique for secretion mass clearance in critical-care patients, its efficacy has not been determined in pediatric patients. Objective:This study investigated the effects of MHI on secretion mass clearance and cardiorespiratory responses in pediatric patients undergoing mechanical ventilation. Methods:A total of 12 intubated and mechanically ventilated pediatric patients were included in this study. At the same time of the day, the patients received two randomly ordered physical therapy treatments (MHI with suction and suction alone) from a trained physical therapist, with a washout period of 4[Formula: see text]h provided between interventions. Results:The MHI treatment increased the tidal volume [[Formula: see text]; 1.2[Formula: see text]mL/kg (95% CI, 0.8–1.5)] and static lung compliance [[Formula: see text]; 3.7[Formula: see text]mL/cmH 2 O (95% CI, 2.6–4.8)] immediately post-intervention compared with the baseline ([Formula: see text]). Moreover, the MHI with suction induced higher [Formula: see text] [1.4[Formula: see text]mL/kg (95% CI, 0.8–2.1)] and [Formula: see text] [3.4[Formula: see text]mL/cmH 2 O (95% CI, 2.1–4.7)] compared with the suction-alone intervention. In addition, the secretion mass [0.7[Formula: see text]g (95% CI, 0.6–0.8)] was greater in MHI with suction compared with suction alone ([Formula: see text]). However, there was no difference in peak inspiratory pressure, mean airway pressure, respiratory rate, heart rate, blood pressure, mean arterial blood pressure or oxygen saturation ([Formula: see text]) between interventions. Conclusions:MHI can improve [Formula: see text], [Formula: see text] and secretion mass without inducing adverse hemodynamic effects upon the pediatric patients requiring mechanical ventilation.