Hodgson C, Denehy L, Ntoumenopoulos G, Santamaria J, Carroll S
Intensive Care Unit, St Vincent's Hospital, Melbourne, Victoria.
Anaesth Intensive Care. 2000 Jun;28(3):255-61. doi: 10.1177/0310057X0002800302.
This prospective within-group multicentre study was designed to assess the safety and short-term effectiveness of manual lung hyperinflation in mechanically 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-lying), suctioning and manual lung hyperinflation. Side-lying treatment involved patient positioning and suctioning alone. Patients received both treatments on the day of data collection. Results demonstrated significant improvement for static respiratory system compliance (P = 0.001) with manual lung hyperinflation treatment compared to side-lying treatment. Manual lung hyperinflation treatment also cleared a significantly greater wet weight of sputum (P = 0.039). There were no differences between manual lung hyperinflation and side-lying treatment for gas exchange (PaO2/FIO2 and PaCO2), mean arterial pressure or heart rate. In conclusion, total static respiratory system compliance and sputum clearance were improved by the addition of manual hyperinflation to a physiotherapy treatment of positioning and suctioning in mechanically ventilated patients without compromise to cardiovascular stability or gas exchange.
这项前瞻性组内多中心研究旨在评估手动肺过度充气对机械通气患者的安全性和短期有效性。来自两家三级医疗机构重症监护病房的18名患者被纳入研究，并作为自身对照。手动肺过度充气治疗包括患者体位摆放（侧卧位）、吸痰和手动肺过度充气。侧卧位治疗仅包括患者体位摆放和吸痰。患者在数据收集当天接受两种治疗。结果表明，与侧卧位治疗相比，手动肺过度充气治疗使静态呼吸系统顺应性有显著改善（P = 0.001）。手动肺过度充气治疗还清除了显著更多湿重的痰液（P = 0.039）。在气体交换（PaO2/FIO2和PaCO2）、平均动脉压或心率方面，手动肺过度充气与侧卧位治疗之间没有差异。总之，在机械通气患者的体位摆放和吸痰物理治疗中增加手动过度充气可改善总静态呼吸系统顺应性和痰液清除，且不影响心血管稳定性或气体交换。
