Abstract
BackgroundManual hyperinflation and expiratory rib cage compression are methods of chest physiotherapy. They are commonly applied but their value and their early utilization managing mechanically ventilated remain questionable. The purpose of the study was to investigate the effects of manual hyperinflation with rib cage compression and endotracheal suctioning on arterial blood gas parameters in mechanically ventilated patients.ResultsSeventy mechanically ventilated patients at a teaching hospital in Egypt were assigned to the clinical trial study. The age of more than half of the studied samples ranged between 60 and 69 years with a mean age of 53.64 ± 16.44 years. Initially, the ABG parameters were assessed. Then, the patients were exposed to manual hyperinflation for 5 min and 20 min external expiratory chest compression followed by endotracheal suctioning. Later, ABG parameters were assessed again and compared to the initial one. The findings revealed significant differences in ABG parameters before and after completion of MHI and ERCC and ETT suctioning in relation to PaO2 (t = 3.892) and SaO2 (t= 5.904). Also, it showed significant improvement in PaO2 and SaO2 after the completion of interventions, while no significant differences were found in other ABG parameters. This study was registered retrospectively with an ISRCTN number 39983 on 5/6/2021.ConclusionApplying manual hyperinflation with rib cage compression and endotracheal suctioning improved mainly the arterial oxygenation parameters in mechanically ventilated patients despite no significant changes observed in other ABG parameters.
Highlights
Manual hyperinflation and expiratory rib cage compression are methods of chest physiotherapy
To fulfill the aim of the study, the following research hypothesis is formulated: Mechanically ventilated patients who expose to the intervention of manual hyperinflation with expiratory rib cage compression followed by open endotracheal suctioning will have improved arterial blood gas parameters than before the intervention
The present study showed that there are no significant differences in the arterial blood gas (ABG) parameters regarding PH, CO2, and HCO3, while showing significant improvement in oxygenation parameters: Partial pressure of oxygen (PaO2) and SaO2
Summary
Manual hyperinflation and expiratory rib cage compression are methods of chest physiotherapy They are commonly applied but their value and their early utilization managing mechanically ventilated remain questionable. Gas exchange impairment may cause serious complications such as respiratory acidosis, cyanosis, and lethal cardiac dysrhythmias, this problem is more severe in patients connected with mechanical ventilation, because the intubation causes irritation of the mucus-producing goblet cells, causing increased of mucous [2]. Prevention of such complications is among the goals of care for these patients. The aim of utilizing hyperinflation is to re-expand the collapsed alveoli, mobilize and eliminate the overflow of bronchial secretions, and make the oxygenation better in mechanically ventilated patients by making larger volume breaths [4, 5]
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