Effect of Manual Hyperinflation with Rib Cage Compression on the Ventilation Outcomes of Mechanically Ventilated Patients

Document Type : Research articles

Authors

1 Assistant Lecturer , Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

2 Assistant professor, Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

3 Professor, Critical care medicine, Faculty of Medicine, Alexandria University

4 Professor, Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Abstract

Background: Critically ill patients on mechanical ventilation usually develop mucus
retention that causes partial or total airway obstruction resulting in atelectasis,
alveolar hypoventilation, and hypoxemia. Therefore, rib cage compression as a
technique for clearing airways act to facilitate secretion clearance and consequently
improve the clinical course of critically ill patients. Objective: To determine the effect
of manual hyperinflation with rib cage compression on the ventilation outcomes of
mechanically ventilated patients. Setting: This study was performed at the general
ICUs of the Alexandria Main University Hospital, namely: unit I, unit II, unit III, unit
IV, and unit V, Egypt. Subjects: A convenient sample of 170 mechanically ventilated
patients who were admitted to the previously mentioned ICUs were enrolled in the
current study. Tool: “Outcomes of manual hyperinflation with rib cage compression
assessment tool” is the tool used to collect the data of this study. Results: The age of
more than one third of the studied groups ranged from 36-55 years with a mean age
of 44.2±12.7 and 43±13 for the intervention and control groups respectively. No
statistically significant differences were found between the APACHE II, and Glasgow
coma scores in the intervention and control groups, where (P=0.13) and (P=0.14)
respectively. There was a significant difference between the intervention and control
groups regarding dynamic compliance, and tidal volume whereas (P=0.04).
Conclusion: The present study demonstrated that the performance of manual
hyperinflation with rib cage compression before tracheal suctioning enhances
ventilation outcomes in mechanically ventilated patients. These combined techniques
help to improve lung compliance as well as tidal and minute volumes.
Recommendations: The nursing staff should perform rib cage compression with other
chest physiotherapy techniques to maximize the benefits for mechanically ventilated
patients. Examine mechanically ventilated patients for more than five days to discover
the long-term effect of the rib cage compression technique.


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