title: Effects of manual rib-cage compression versus PEEP-ZEEP maneuver on respiratory system compliance and oxygenation in patients receiving mechanical ventilation.
abstract: OBJECTIVE
  Patients unable to perform breathing functions may be submitted to invasive mechanical ventilation. Chest physiotherapy acts directly on the treatment of these patients for the purpose of improving their lung function. The objective of this study was to evaluate the effects of manual rib-cage compression versus the positive end expiratory pressure-zero end expiratory pressure (PEEP-ZEEP) maneuver, on compliance of the respiratory system and oxygenation in patients under invasive mechanical ventilation.
  
  
  METHODS
  A double centric, prospective, randomized and crossover study, with patients under invasive mechanical ventilation, in controlled mode for more than 48 hours was carried out. The protocols of chest physiothe-rapy were randomly applied at an interval of 24 hours. Data of respiratory system compliance and oxygenation were collected before application of the protocols and 30 minutes after.
  
  
  RESULTS
  Twelve patients completed the study. Intragroup analysis, for both techniques showed a statistically significant difference in tidal volume (p=0.002), static compliance (p=0.002) and dynamic compliance (p=0.002). In relation to oxygenation, in the group of manual rib-cage compression, peripheral oxygen saturation increased with a significant difference (p=0.011).
  
  
  CONCLUSIONS
  Manual rib-cage compression and PEEP-ZEEP maneuver have positive clinical effects. In relation to oxygenation we found a favorable behavior of peripheral oxygen saturation in the group of manual rib-cage compression.
authors.affiliation: Centro Universitário Metodista IPA, Porto Alegre, RS, Brasil.
authors.forename: Flavio Renato Antunes Dos
authors.initials: FR
authors.lastname: Santos
authors.affiliation: Unidade de Terapia Intensiva, Hospital São Francisco, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Schneider Júnior
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Forgiarini Junior
authors.affiliation: Centro Universitário Metodista IPA, Porto Alegre, RS, Brasil.
authors.forename: Jefferson
authors.initials: J
authors.lastname: Veronezi