title: Effects of manual hyperinflation maneuver associated with positive end expiratory pressure in patients within coronary artery bypass grafting.
abstract: OBJECTIVE
  To verify the effects of manual hyperinflation maneuver associated with positive end expiratory pressure in coronary artery bypass grafting patients.
  
  
  METHODS
  This was a randomized trial, conducted from August 2007 to July 2008 in the intensive care unit of the Hospital Luterano (ULBRA). The patients were divided in the groups intervention - with manual hyperinflation plus positive end expiratory pressure - and controlThe ventilatory variables were measured before and after the manual hyperinflation. The t Student's test was used for independent and paired samples as well as Fisher's exact test and McNemar's Chi-square test with 0.05 significance level.
  
  
  RESULTS
  Eighteen patients were included. The mean age was 64± 11 years and 55.6% were female. The inspired tidal volume was 594± 112ml in the intervention group and 487± 51ml in the control group (p=0.024) and the expired tidal volume was 598± 105ml in the intervention group and 490± 58ml in the control group (p=0.02). The mean pre-maneuver static pulmonary compliance in the intervention group was 41.6± 12.1 ml/cmH2O and post maneuver it was 47.4± 16.6 ml/cmH2O (p=0.03). There was no significant between groups difference in the following variables: oxygen peripheral saturation, oxygen arterial pressure, extubation time and radiological changes.
  
  
  CONCLUSIONS
  The results show that the manual hyperinflation associated with positive end expiratory pressure maneuver trends to promote increased lung volumes and static compliance, however these findings require further confirmation.
authors.affiliation: Curso de Fisioterapia, Universidade Luterana do Brasil - ULBRA.
authors.forename: Laura Jurema Dos
authors.initials: LJ
authors.lastname: Santos
authors.affiliation: Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS.
authors.forename: Clarissa Netto
authors.initials: CN
authors.lastname: Blattner
authors.affiliation: Universidade Luterana do Brasil - ULBRA, Canoas, RS, Brasil.
authors.forename: César Augusto Bini
authors.initials: CA
authors.lastname: Micol
authors.affiliation: Universidade Luterana do Brasil - ULBRA, Canoas, RS, Brasil.
authors.forename: Fernanda Abreu Miceli
authors.initials: FA
authors.lastname: Pinto
authors.affiliation: Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Andressa
authors.initials: A
authors.lastname: Renon
authors.affiliation: Hospital Mãe de Deus, Porto Alegre, RS, Brasil.
authors.forename: Renata
authors.initials: R
authors.lastname: Pletsch