Manual hyperinflation improves alveolar recruitment in difficult-to-wean patients.
OBJECTIVE
To investigate the effect of manual hyperinflation (MH) in patients with atelectasis associated with ventilation support.


METHODS
Patients were randomized to either an experimental group or a control group.


METHODS
Pulmonary ICUs from two hospitals.


METHODS
Twenty-three patients with atelectasis associated with ventilation support.


METHODS
The MH technique was at a rate of 8 to 13 breaths/min for a period of 20 min each session, three times per day for 5 days. The control group received their standard prescribed mechanical ventilation without supplemental MH. Sputum contents (wet/dry weight ratio, viscosity), respiratory system capacity (spontaneous tidal volume [Vt], maximal inspiratory pressure, rapid shallow breathing index [f/Vt], chest radiograph signs, and Pa(O2)/fraction of inspired oxygen [Fi(O2)]) were measured just prior to the MH at day 0 as baseline, and at day 3 and day 6 of the study.


RESULTS
There were significant improvements in scores over the 6-day study in the experimental group compared to the control group in spontaneous Vt (p = 0.035) and chest radiograph signs (p = 0.040), and a trend toward improvement of f/Vt (p = 0.066) and Pa(O2)/Fi(O2) (p = 0.061) after adjustment for covariates. Other outcome variables did not differ significantly between the experimental and control groups.


CONCLUSIONS
MH performed on patients with atelectasis from ventilation support significantly improved alveolar recruitment.
Maa
Suh-Hwa
SH
School of Nursing, Chang Gung University, 259, Wen-Hwa First Rd, Kwei-San, Tao-Yuan, Taiwan, ROC. shmaa@mail.cgu.edu.tw
Hung
Tzong-Jen
TJ
Hsu
Kuang-Hung
KH
Hsieh
Ya-I
YI
Wang
Kwua-Yun
KY
Wang
Chun-Hua
CH
Lin
Horng-Chyuan
HC
D000368:Aged; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods; D007442:Intubation, Intratracheal / Q000379:methods; D008171:Lung Diseases / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000503:physiopathology*; D001261:Pulmonary Atelectasis / Q000209:etiology* / Q000503:physiopathology; D012138:Respiratory Therapy; D015300:Ventilator Weaning / Q000009:adverse effects* / Q000379:methods