An investigation of the early effects of manual lung hyperinflation in critically ill patients

This prospective within-group multicentre study was designed to assess the safety and short-term effectiveness of manual lung hyperinflation in mechan ically ventilated patients, Eighteen patients from the intensive care units of two tertiary institutions were included and acted as their own control. Manual lung hyperinflation treatment involved patient positioning (side-ly ing), suctioning and manual lung hyperinflation. Sine-lying treatment invol ved patient positioning and suctioning alone. Patients received both treatm ents on the day of data collection. Results demonstrated significant improv ement for static respiratory system compliance (P=0.001) with manual lung h yperinflation treatment compared to side-lying treatment. Manual lung hyper inflation treatment also cleared a significantly greater wet weight of sput um (P=0.039). There were no differences between manual lung hyperinflation and side-lying treatment for gas exchange (PaO2/FIO2 and PaCO2), mean arter ial pressure or heart rate. In conclusion total static respiratory system c ompliance and sputum clearance were improved by the addition of manual hype rinflation to a physiotherapy treatment of positioning and suctioning in me chanically ventilated patients without compromise to cardiovascular stabili ty or gas exchange.