Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/55667
Title: Effects of manual hyperinflation and suctioning on respiratory mechanics in mechanically ventilated patients with ventilator-associated pneumonia
Authors: Choi, J
Jones, AYM
Keywords: Manual hyperinflation
Mechanical ventilation
Physical therapy
Respiratory mechanics
Tracheal suction
Issue Date: 2005
Publisher: Elsevier
Source: Australian journal of physiotherapy, 2005, v. 51 , no. 1, p. 25-30 How to cite?
Journal: Australian journal of physiotherapy 
Abstract: Ventilator-associated pneumonia results from bacterial colonisation of the aerodigestive tract or aspiration of contaminated secretions into the lower airways. As a consequence of infection of the lung parenchyma and alveolitis, accumulation of inflammatory exudates and infiltration of airway mucosa can lead to unfavourable respiratory mechanics in ventilator-associated pneumonia. Tracheal suction is often employed by nursing staff in the management of mechanically ventilated patients with ventilator-associated pneumonia but this technique has the potential to increase respiratory resistance. Manual hyperinflation is used by physiotherapists to improve lung volume and mobilise secretions and has been shown to increase lung compliance. The effect of manual hyperinflation on airway resistance has not been studied. This study aims to demonstrate an additional mechanical benefit to the respiratory system whe manual hyperinflation and suction techniques are combined, by comparing the application of manual hyperinflation and suction with suction alone on static lung compliance (CL) and inspiratory resistance (RAW) in mechanically ventilated patients with ventilator-associated pneumonia. Fifteen adult patients with ventilator-associated pneumonia were recruited and acted as their own controls. Manual hyperinflation followed by suction (manual hyperinflation plus suction) and suction alone were applied consecutively, in random order, on two occasions, four hours apart. Respiratory variables, CL and RAW, were measured five times and the averaged value documented. Data were recorded before, immediately after, and 30 minutes after each intervention protocol. CL increased by 22% and RAW decreased by 21% up to 30 minutes after manual hyperinflation plus suction, but not after suction alone. This study suggests that manual hyperinflation in conjunction with suction induces beneficial changes in respiratory mechanics in mechanically ventilated patients with ventilator-associated pneumonia.
URI: http://hdl.handle.net/10397/55667
ISSN: 0004-9514
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