The effects of manual hyperinflation on static compliance and static inspiratory resistance of the respiratory system in mechanically ventilated patients with ventilator-associated pneumonia

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The effects of manual hyperinflation on static compliance and static inspiratory resistance of the respiratory system in mechanically ventilated patients with ventilator-associated pneumonia

 

Author: Choi, Siu-ping Jessica
Title: The effects of manual hyperinflation on static compliance and static inspiratory resistance of the respiratory system in mechanically ventilated patients with ventilator-associated pneumonia
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Respiratory therapy
Pneumonia -- Patients -- Rehabilitation
Artificial respiration
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xii, 60 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1714731
URI: http://theses.lib.polyu.edu.hk/handle/200/897
Abstract: Manual hyperinflation is a technique commonly used by physiotherapists in the management of mechanically ventilated patients in the intensive care unit (ICU). It aims to remove excessive bronchial secretions, reinflate areas of atelectasis, improve the oxygenation and lung compliance. Ventilator-associated pneumonia (VAP) is nosocomial pneumonia associated with mechanical ventilation which occurs at least 48 hours after intubation and ventilation. Development of VAP significantly increases morbidity, mortality and length of stay of patients in ICU. This study adopts a one group pretest-posttest design which aimed to evaluate the effects of manual hyperinflation on the static compliance and static inspiratory resistance of the respiratory system in mechanically ventilated patients suffering from VAP. Fifteen mechanically ventilated adult patients diagnosed with VAP in the ICU of the Queen Elizabeth Hospital were recruited and acted as their own control. "Manual hyperinflation intervention" involved normal saline instillation, four sets of eight breaths of hyperinflation followed by suctioning, whereas "suctioning-only intervention" involved normal saline instillation and suctioning only. Each patient received both interventions in random order on the day of data collection and with a minimum of four hours interval in between to minimize the carrying over effect. Static respiratory compliance and static inspiratory resistance were measured by the Neilcor Puritan Bennett 840 Ventilator. The data were analyzed using the SPSS for Window version 10.0. Repeated-measures ANOVA was used for data analysis. Results demonstrated significant improvement in static respiratory compliance from pre-manual hyperinflation (35.2 +- 4.9 ml/cmH2O) to post-manual hyperinflation (43.1 +- 6.4 ml/cmH2O), and the increase in compliance was maintained for at least 30 minutes after manual hyperinflation (43.5+-6.7 ml/cmH2O) (P<0.001). Moreover, results demonshated significant decrease in static inspiratory resistance from baseline (11.0+-4.2 cmH2O/L/sec) to 30 minutes post-manual hyperinflation (8.7+-3.2 cmH2O/L/sec) (P=0.004). However, there was no significant change of static respiratory compliance and static inspiratory resistance after the suctioning-only intervention. In conclusion, manual hyperinflation followed by suctioning was able to increase static respiratory compliance and reduce static inspiratory resistance in mechanically ventilated patients diagnosed with VAP.

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