title: Manual hyperinflation improves alveolar recruitment in difficult-to-wean patients.
abstract: 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.
authors.affiliation: School of Nursing, Chang Gung University, 259, Wen-Hwa First Rd, Kwei-San, Tao-Yuan, Taiwan, ROC. shmaa@mail.cgu.edu.tw
authors.forename: Suh-Hwa
authors.initials: SH
authors.lastname: Maa
authors.forename: Tzong-Jen
authors.initials: TJ
authors.lastname: Hung
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
authors.forename: Ya-I
authors.initials: YI
authors.lastname: Hsieh
authors.forename: Kwua-Yun
authors.initials: KY
authors.lastname: Wang
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Wang
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
mesh_terms: 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