[Effects of manually assisted coughing on respiratory mechanics in patients requiring full ventilatory support].
OBJECTIVE
Manually assisted coughing (MAC) consists of a vigorous thrust applied to the chest at the beginning of a spontaneous expiration or of the expiratory phase of mechanical ventilation. Due to routine use of MAC in intensive care units, the objective of this study was to assess the effects of MAC on respiratory system mechanics in patients requiring full ventilatory support.


METHODS
We assessed 16 sedated patients on full ventilatory support (no active participation in ventilation). Respiratory system mechanics and oxyhemoglobin saturation were measured before and after MAC, as well as after endotracheal aspiration. Bilateral MAC was performed ten times on each patient, with three respiratory cycle intervals between each application.


RESULTS
Data analysis demonstrated a decrease in resistive pressure and respiratory system resistance, together with an increase in oxyhemoglobin saturation, after MAC combined with endotracheal aspiration. No evidence of alterations in peak pressures, plateau pressures or respiratory system compliance change was observed after MAC.


CONCLUSIONS
The use of MAC alters respiratory system mechanics, increasing resistive forces by removing secretions. The technique is considered safe and efficacious for postoperative patients. Using MAC in conjunction with endotracheal aspiration provided benefits, achieving the proposed objective: the displacement and removal of airway secretions.
Avena
Katia de Miranda
Kde M
Centro Universitário do Triângulo, Uberlândia, MG, Brasil.
Duarte
Antonio Carlos Magalhães
AC
Cravo
Sergio Luiz Domingues
SL
Sologuren
Maria José Junho
MJ
Gastaldi
Ada Clarice
AC
D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D003371:Cough / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D010108:Oxyhemoglobins / Q000032:analysis; D011182:Postoperative Care; D012121:Respiration, Artificial; D015656:Respiratory Mechanics / Q000502:physiology*; D013997:Time Factors
D010108:Oxyhemoglobins