title: Oxygenation and static compliance is improved immediately after early manual hyperinflation following myocardial revascularisation: a randomised controlled trial.
abstract: OBJECTIVE
  Are oxygenation and static compliance improved immediately after manual hyperinflation following myocardial revascularisation? Does this lead to earlier extubation and shorter hospital stay? Does it reduce postoperative pulmonary complications?
  
  
  METHODS
  Randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis.
  
  
  METHODS
  Fifty-five patients who underwent myocardial revascularisation.
  
  
  METHODS
  After an hour in recovery, the experimental group received manual hyperinflation with positive end expiratory pressure followed by suction while the control group received suction only.
  
  
  METHODS
  Oxygenation (PaO(2) in mmHg) and static lung compliance (in ml/cmH(2)O) were measured immediately after suction. Time to extubation (in minutes) and length of hospital stay (in days) were collected and postoperative pulmonary complications were confirmed by X-ray.
  
  
  RESULTS
  PaO(2) was 11.7 mmHg (95% CI 9.4 to 14.0) greater in the experimental group while static compliance was 8.5 ml/cmH(2)0 (95% CI 6.4 to 10.6) greater than in the control group. The experimental group was extubated 76 minutes (95% CI 24 to 128) earlier than the control group but did not have a shorter length of stay (mean difference 0.5 days, 95% CI -0.2 to 1.2). The relative risk of postoperative pulmonary complications was no greater (RR 0.57, 95% Cl 0.20 to 1.60) in the experimental group than in the control group.
  
  
  CONCLUSIONS
  The group that received early manual hyperinflation had markedly better oxygenation and static compliance as well as shorter mechanical ventilation times than the control group. The length of hospital stay and incidence of postoperative pulmonary complications were similar in the two groups.
authors: Physiotherapy, Hospital São Lucas, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil. cblattner@terra.com.br
authors: Clarissa
authors: C
authors: Blattner
authors: João Carlos
authors: JC
authors: Guaragna
authors: Eduardo
authors: E
authors: Saadi
mesh_terms: D005260:Female; D006801:Humans; D007902:Length of Stay; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D009204:Myocardial Revascularization; D026741:Physical Therapy Modalities; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000517:prevention & control; D012123:Pulmonary Ventilation / Q000502:physiology*; D012121:Respiration, Artificial / Q000379:methods*; D016037:Single-Blind Method; D013990:Tidal Volume / Q000502:physiology; D016896:Treatment Outcome