title: Effect of mechanical chest percussion on intracranial pressure: a pilot study.
abstract: BACKGROUND
  Treatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdotal evidence indicates that physical stimulation increases intracranial pressure and should be avoided in patients at risk of intracranial hypertension.
  
  
  OBJECTIVE
  To explore the safety of performing chest percussion for patients at high risk for intracranial hypertension.
  
  
  METHODS
  A total of 28 patients with at least 1 documented episode of intracranial hypertension who were having intracranial pressure monitored were studied in a prospective randomized control trial. Patients were randomly assigned to either the control group (no chest percussion) or the intervention group (10 minutes of chest percussion at noon). Intracranial pressure was recorded once a minute before, during, and after the intervention.
  
  
  RESULTS
  Mean intracranial pressures for the control group before, during, and after the study period (14.4, 15.0, and 15.9 mm Hg, respectively) did not differ significantly from pressures in the intervention group (13.6, 13.7, and 14.2 mm Hg, respectively).
  
  
  CONCLUSIONS
  Mechanical chest percussion may be a safe intervention for nurses to use on neurologically injured patients who are at risk for intracranial hypertension.
authors.affiliation: Duke University Medical Center, Durham, North Carolina, USA. Olson006@mc.duke.edu
authors.forename: DaiWai M
authors.initials: DM
authors.lastname: Olson
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Thoyre
authors.forename: Stacey N
authors.initials: SN
authors.lastname: Bennett
authors.forename: Joanna B
authors.initials: JB
authors.lastname: Stoner
authors.forename: Carmelo
authors.initials: C
authors.lastname: Graffagnino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000503:physiopathology*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000503:physiopathology* / Q000517:prevention & control; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010474:Percussion / Q000009:adverse effects*; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D013909:Thorax; D055815:Young Adult