title: Ventilatory characteristics in mechanically ventilated patients during manual hyperventilation for chest physiotherapy.
abstract: We measured the tidal volumes and peak inflation pressures generated during manual hyperventilation for chest physiotherapy in 25 adult ventilated patients. The average tidal volume ranged from 711 to 1511 ml, with a mean (SD) of 1120 (274) ml. There was a negative correlation (p < 0.05) between the average tidal volume and the lung injury, as measured by the Murray lung injury score. The average peak inflation pressure ranged from 37 to 74 cmH2O with a mean (SD) of 51.5 (7.6) cmH2O. There was a positive correlation (p < 0.05) between average peak inflation pressure and the lung injury score. Mean (SD) PaO2 improved by 18.3 (14.3) kPa from baseline after physiotherapy (p < 0.05). Mean (SD) PaCO2 decreased by 0.1 (0.4) kPa. As the lung score increases higher inflation pressures and smaller tidal volumes are used suggesting an increased potential for barotrauma or volutrauma in susceptible lungs.
authors.affiliation: Regional Intensive Care Unit, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland.
authors.forename: R C
authors.initials: RC
authors.lastname: Clarke
authors.forename: B E
authors.initials: BE
authors.lastname: Kelly
authors.forename: P N
authors.initials: PN
authors.lastname: Convery
authors.forename: J P
authors.initials: JP
authors.lastname: Fee
mesh_terms: D000328:Adult; D000368:Aged; D000399:Air Pressure; D001469:Barotrauma / Q000209:etiology; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology; D008171:Lung Diseases / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000009:adverse effects / Q000379:methods*; D012121:Respiration, Artificial / Q000009:adverse effects; D015656:Respiratory Mechanics; D013990:Tidal Volume