title: Bronchial hygiene technique with manual hyperinflation and thoracic compression: effectiveness and safety.
abstract: OBJECTIVE
  To evaluate the effects of the manual hyperinflation with thoracic compression (MHTC) maneuver on the clearance of secretions, pulmonary mechanics, hemodynamics and oxygenation in mechanically ventilated patients.
  
  
  METHODS
  This was a controlled, crossover study that included twenty patients who were under invasive ventilation for more than 48 hours. Four hours after the last airway suctioning procedure, the patients underwent the study interventions, Suction alone or MHTC plus Suction, in sequence at four hour intervals. The sequence order for the procedures was established by randomization. Data were collected before, during and 5, 15, 30 and 60 minutes after each intervention. The suctioned secretions were collected and weighed.
  
  
  RESULTS
  No significant differences between the procedures were found regarding tidal volume, plateau pressure and pulmonary compliance (p>0.05). The hemodynamic variables showed increased pressures and heart rate during the procedures and returned to baseline values five minutes after the end of the procedure (p≤0.001). No significant hemodynamic differences were seen between the interventions (p>0.05). For the duration of the study, oxygen saturation was 99% with only two exceptions during the MHTC + Suction procedure, where saturation was 98% (p<0.05). No significant differences were observed between the techniques regarding the weight of the suctioned secretion.
  
  
  CONCLUSIONS
  The results suggest that MHTC, as performed in this study, adds no benefit with respect to oxygenation optimization, pulmonary mechanics and clearance of secretions. However, the MHTC maneuver did not result in hemodynamic changes when compared to the suctioning procedure alone.
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Camila Marques
authors.initials: CM
authors.lastname: Dias
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Tatiane Martins
authors.initials: TM
authors.lastname: Siqueira
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Tatiane Regina
authors.initials: TR
authors.lastname: Faccio
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Luciana Costa
authors.initials: LC
authors.lastname: Gontijo
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Juliana Almeida de Souza Borges
authors.initials: JA
authors.lastname: Salge
authors.affiliation: Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil.
authors.forename: Marcia Souza
authors.initials: MS
authors.lastname: Volpe