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Manual hyperinflation

Marcia S Volpe, Juliane M Naves, Gabriel G Ribeiro, Gualberto Ruas, Mauro R Tucci
INTRODUCTION: Manual hyperinflation (MH), a maneuver applied in mechanically ventilated patients to facilitate secretion removal, has large variation in its performance. Effectiveness of MH is usually evaluated by its capacity to generate an expiratory flow bias. The aim of this study was to compare the effects of MH-and its resulting flow bias-applied according to clinical practice versus according to expert recommendation on mucus movement in a lung model simulating a mechanically ventilated patient...
2018: PloS One
George Ntoumenopoulos, Naomi Hammond, Nicola R Watts, Kelly Thompson, Gabrielle Hanlon, Jennifer D Paratz, Peter Thomas
INTRODUCTION/AIMS: To describe the processes of care for secretion clearance in adult, intubated and mechanically ventilated patients in Australian and New Zealand Intensive Care Units (ICUs). METHODS/RESULTS: A prospective, cross-sectional study was conducted through the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) Point Prevalence Program. Forty-seven ICUs collected data from 230 patients intubated and ventilated on the study day...
June 26, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Herbert D Spapen, Jouke De Regt, Patrick M Honoré
A beneficial adjuvant role of chest physiotherapy (CPT) to promote airway clearance, alveolar recruitment, and ventilation/perfusion matching in mechanically ventilated (MV) patients with pneumonia or relapsing lung atelectasis is commonly accepted. However, doubt prevails regarding the usefulness of applying routine CPT in MV subjects with no such lung diseases. In-depth narrative review based on a literature search for prospective randomized trials comparing CPT with a non-CPT strategy in adult patients ventilated for at least 48 h...
January 2017: Journal of Thoracic Disease
Vanessa Pereira Lima, Vinicius C Iamonti, Marcelo Velloso, Tania Janaudis-Ferreira
PURPOSE: The mechanisms underlying physiological limitations during arm activity in individuals with chronic obstructive pulmonary disease (COPD) are unknown. The objective of this systematic review was to describe cardiorespiratory responses, symptoms, chest wall kinematics, muscle activity, and lung volumes during arm activity in individuals with COPD relative to the responses of healthy controls. METHODS: Original research articles that compared cardiorespiratory responses, symptoms, muscle activity, chest wall kinematics, and lung function during arm activity between individuals with COPD and healthy controls were identified after searches of 5 electronic databases and reference lists of pertinent articles...
November 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
Camila Chaves Viana, Carla Marques Nicolau, Regina Celia Turola Passos Juliani, Werther Brunow de Carvalho, Vera Lucia Jornada Krebs
OBJECTIVE: To assess the effects of manual hyperinflation, performed with a manual resuscitator with and without the positive end-expiratory pressure valve, on the respiratory function of preterm newborns under mechanical ventilation. METHODS: Cross-sectional study of hemodynamically stable preterm newborns with gestational age of less than 32 weeks, under mechanical ventilation and dependent on it at 28 days of life. Manual hyperinflation was applied randomly, alternating the use or not of the positive end-expiratory pressure valve, followed by tracheal aspiration for ending the maneuver...
September 2016: Revista Brasileira de Terapia Intensiva
Simon Veldhoen, Andreas M Weng, Janine Knapp, Andreas S Kunz, Daniel Stäb, Clemens Wirth, Florian Segerer, Helge Hebestreit, Uwe Malzahn, Herbert Köstler, Thorsten A Bley
Purpose To assess the clinical feasibility of self-gated non-contrast-enhanced functional lung (SENCEFUL) magnetic resonance (MR) imaging for quantitative ventilation (QV) imaging in patients with cystic fibrosis (CF). Materials and Methods Twenty patients with CF and 20 matched healthy volunteers underwent functional 1.5-T lung MR imaging with the SENCEFUL imaging approach, in which a two-dimensional fast low-angle shot sequence is used with quasi-random sampling. The lungs were manually segmented on the ventilation-weighted images to obtain QV measurements, which were compared between groups...
April 2017: Radiology
Giuseppe Natalini, Daniele Tuzzo, Antonio Rosano, Marco Testa, Michele Grazioli, Vincenzo Pennestrì, Guido Amodeo, Francesco Berruto, Marialinda Fiorillo, Alberto Peratoner, Andrea Tinnirello, Matteo Filippini, Paolo F Marsilia, Cosetta Minelli, Achille Bernardini
BACKGROUND: In some patients with auto-positive end-expiratory pressure (auto-PEEP), application of PEEP lower than auto-PEEP maintains a constant total PEEP, therefore reducing the inspiratory threshold load without detrimental cardiovascular or respiratory effects. We refer to these patients as "complete PEEP-absorbers." Conversely, adverse effects of PEEP application could occur in patients with auto-PEEP when the total PEEP rises as a consequence. From a pathophysiological perspective, all subjects with flow limitation are expected to be "complete PEEP-absorbers," whereas PEEP should increase total PEEP in all other patients...
December 2016: Annals of Intensive Care
Diane M Dennis, Christine N Duncan, Mary Pinder, Charley A Budgeon, Wendy J Jacob
AIMS AND OBJECTIVES: To assess the consistency and safety of manual hyperinflation delivery by nurses of variable clinical experience using a resuscitator bag during physiotherapy treatment. BACKGROUND: Manual hyperinflation involves the delivery of larger than normal gas volumes to intubated patients and is routinely used by nurses in collaboration with physiotherapists for the management of retained sputum. The aim is to deliver slow deep breaths with an inspiratory hold without unsafe airway pressures, lung volumes or haemodynamic changes...
August 2016: Journal of Clinical Nursing
Ponsuge Chathurani Sigera, Tunpattu Mudiyanselage Upul Sanjeewa Tunpattu, Thambawitage Pasan Jayashantha, Ambepitiyawaduge Pubudu De Silva, Priyantha Lakmini Athapattu, Arjen Dondorp, Rashan Haniffa
BACKGROUND: The availability and role of physical therapists in critical care is variable in resource-poor settings, including lower middle-income countries. OBJECTIVE: The aim of this study was to determine: (1) the availability of critical care physical therapist services, (2) the equipment and techniques used and needed, and (3) the training and continuous professional development of physical therapists. METHODS: All physical therapists working in critical care units (CCUs) of state hospitals in Sri Lanka were contacted...
July 2016: Physical Therapy
Farbod N Rahaghi, Carolyn E Come, James Ross, Rola Harmouche, Alejandro A Diaz, Raul San Jose Estepar, George Washko
INTRODUCTION: Endoscopic Lung Volume Reduction has been used to reduce lung hyperinflation in selected patients with severe emphysema. Little is known about the effect of this procedure on the intraparenchymal pulmonary vasculature. In this study we used CT based vascular reconstruction to quantify the effect of the procedure on the pulmonary vasculature. METHODS: Intraparenchymal vasculature was reconstructed and quantified in 12 patients with CT scans at baseline and 12 weeks following bilateral introduction of sealants in the upper lobes...
2015: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Karin Klooster, Nick H T ten Hacken, Jorine E Hartman, Frank C Sciurba, Huib A M Kerstjens, Dirk-Jan Slebos
BACKGROUND: Dynamic hyperinflation due to increased respiratory frequency during exercise is associated with limitations in exercise capacity in patients with moderately severe chronic obstructive pulmonary disease (COPD). OBJECTIVES: The present study assessed whether the manually paced tachypnea (MPT) test, sitting at rest, induces dynamic hyperinflation correlating with exercise capacity in patients with very severe COPD. METHODS: Dynamic hyperinflation was induced by the MPT test, using a breathing frequency of 40/min for 1 min...
2015: Respiration; International Review of Thoracic Diseases
Bradley G Bennett, Peter Thomas, George Ntoumenopoulos
BACKGROUND: Manual hyperinflation can be used to assist mucus clearance in intubated patients. The technique's effectiveness to move mucus is underpinned by its ability to generate flow bias in the direction of expiration, and this must exceed specific thresholds. It is unclear whether the inspiratory times commonly used by physiotherapists generate sufficient expiratory flow bias based on previously published thresholds and whether factors such as lung compliance affect this. METHODS: In a series of laboratory experiments, we applied manual hyperinflation to a bench model to examine the role of 3 target inspiratory times and 2 lung compliance settings on 3 measures of expiratory flow bias...
October 2015: Respiratory Care
U Frank, K Frank, H Zimmermann
OBJECTIVE: Tracheotomized patients often suffer from impairments in mucociliary clearance and limited capacities for active expectoration of secretions. We investigated the effects of a specific respiratory intervention method (bagging) for tracheotomized patients on respiratory parameters (pO2, pCO2, SpO2, respiratory rates), swallowing frequency, vigilance and secretion viscosity. METHODS: The bagging method supports enforced mobilization and expectoration of secretions by application of a series of manual hyperinflations with a resuscitation bag during active inspiration and manual cough support on the chest...
July 2015: Pneumologie
Ellie Hawkins, Anne Jones
BACKGROUND: Physiotherapy in intensive care units (ICU) has traditionally focussed on the respiratory management of mechanically ventilated patients. Gradually, focus has shifted to include rehabilitation in adult ICUs, though evidence of a similar shift in the paediatric ICU (PICU) is limited. OBJECTIVES: Review the evidence to determine the role of physiotherapists in the management of mechanically ventilated patients in PICU. DATA SOURCES: A search was conducted of: PEDro, CINAHL, Medline, PubMed and the Cochrane Library...
December 2015: Physiotherapy
Malathi C Nandihalli, Srinivas H Thammaiah, Nalini Kotekar, Prashanth R Putran
Congenital lobar emphysema (CLE) is a potentially reversible, though life-threatening cause of respiratory distress in neonates. It is a rare developmental anomaly of the lower respiratory tract. A 10-month-old child presented with fever, cough and difficulty in breathing. Respiratory system examination revealed tachypnea with intercostal retraction, decreased breath sounds over the left upper lobe and room air saturation of 95%. Chest radiograph and computed tomography showed hyperinflated left upper zones with mediastinal shift...
January 2015: Indian Journal of Critical Care Medicine
A Anderson, J Alexanders, C Sinani, S Hayes, M Fogarty
BACKGROUND: Ventilator hyperinflation (VHI) and manual hyperinflation (MHI) are thought to improve secretion clearance, atelectasis and oxygenation in adults receiving mechanical ventilation. However, to the authors' knowledge, a systematic review of their relative effectiveness has not been undertaken previously. OBJECTIVE: To determine whether VHI is more effective than MHI for the improvement of clinical outcomes in adults receiving mechanical ventilation. DATA SOURCES: The electronic databases PubMed, Cochrane Library, CINHAL Plus, Wiley Online Library, ScienceDirect and PEDro were searched from January 1993 until August 2013...
June 2015: Physiotherapy
F Paulus, Dp Veelo, Sb De Nijs, P Bresser, Ba De Mol, Lf Beenen, Jm Binnekade, Mj Schultz
No abstract text is available yet for this article.
2011: Critical Care: the Official Journal of the Critical Care Forum
Daniela Aires Lemes, Fernando Silva Guimarães
BACKGROUND AND OBJECTIVES: Mechanically ventilated patients usually present larger amounts of pulmonary secretions because of impairment in mucociliary function and mucus transport. The manual resuscitator is considered a resource for pulmonary hyperinflation with the aim of preventing mucus retention and pulmonary complications, improving oxygenation and reexpanding collapsed areas. Alternatively, the hyperinflation by mechanical ventilator is a reliable and practical device to promote lung expansion and desobstruction...
June 2007: Revista Brasileira de Terapia Intensiva
Laura Jurema Dos Santos, Clarissa Netto Blattner, César Augusto Bini Micol, Fernanda Abreu Miceli Pinto, Andressa Renon, Renata Pletsch
OBJECTIVE: To verify the effects of manual hyperinflation maneuver associated with positive end expiratory pressure in coronary artery bypass grafting patients. METHODS: This was a randomized trial, conducted from August 2007 to July 2008 in the intensive care unit of the Hospital Luterano (ULBRA). The patients were divided in the groups intervention - with manual hyperinflation plus positive end expiratory pressure - and controlThe ventilatory variables were measured before and after the manual hyperinflation...
March 2010: Revista Brasileira de Terapia Intensiva
Camila Marques Dias, Tatiane Martins Siqueira, Tatiane Regina Faccio, Luciana Costa Gontijo, Juliana Almeida de Souza Borges Salge, Marcia Souza Volpe
OBJECTIVES: To evaluate the effects of the manual hyperinflation with thoracic compression (MHTC) maneuver on the clearance of secretions, pulmonary mechanics, hemodynamics and oxygenation in mechanically ventilated patients. METHODS: This was a controlled, crossover study that included twenty patients who were under invasive ventilation for more than 48 hours. Four hours after the last airway suctioning procedure, the patients underwent the study interventions, Suction alone or MHTC plus Suction, in sequence at four hour intervals...
June 2011: Revista Brasileira de Terapia Intensiva
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