Physiotherapy research international : the journal for researchers and clinicians in physical therapy
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Randomized Controlled Trial Comparative Study Clinical Trial
An evaluation of a single chest physiotherapy treatment on mechanically ventilated patients with acute lung injury.
Acute lung injury is a lung pathology that presents frequently on the intensive care unit. Chest physiotherapy, in the form of endotracheal suction, alternate side-lying and manual hyperinflation, is usually given to patients with this condition with the intention of removing retained pulmonary secretions and recruiting collapsed distal lung units. Despite this common practice there is insufficient research on the effects of chest physiotherapy in patients with acute lung injury being ventilated mechanically. The aim of the present study was to further understanding of the effects of three modes of treatment in chest physiotherapy in an acute lung injury patient group. ⋯ Patients with acute lung injury are notably complex to nurse and may require protracted physiotherapy intervention, which may take many forms. As de-recruitment was the single most important event that occurred in the present study population, a prescriptive chest physiotherapy approach to treating mechanically ventilated patients with acute lung should be questioned and adapted accordingly.
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Randomized Controlled Trial Clinical Trial
A comparison of the effects of manual and ventilator hyperinflation on static lung compliance and sputum production in intubated and ventilated intensive care patients.
Lung hyperinflation is a technique used by physiotherapists to mobilize and remove excess bronchial secretions, reinflate areas of pulmonary collapse and improve oxygenation. Hyperinflation may be delivered by the ventilator or manually, by use of a manual resuscitation circuit, depending upon the respiratory and cardiovascular status of the patient. The effects of manual hyperinflation, with respect to excess bronchial secretions and static lung compliance, have been well-established. There is, however, only limited evidence as to the efficacy of ventilator hyperinflation as a physiotherapy treatment technique. The purpose of the present study was to compare the effects of manual hyperinflation and ventilator hyperinflation on static pulmonary compliance and sputum clearance in stable intubated and ventilated patients. ⋯ Hyperinflation as part of a physiotherapy treatment can be performed with equal benefit using either a manual resuscitation circuit or a ventilator. Both methods of hyperinflation improve static pulmonary compliance and clear similar volumes of pulmonary secretions.