Yazdani Mahboube, Malekzadeh Javad, Sedaghat Alireza, Mazlom Seyed Reza, Pasandideh Khajebeyk Aliyeh
Department Intensive Care Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Prehospital Emergency Care, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
J Caring Sci. 2021 Sep 29;10(4):216-222. doi: 10.34172/jcs.2021.034. eCollection 2021 Nov.
After abdominal surgery, the patients who are separated from mechanical ventilation and provided with oxygen therapy via a T-piece are at risk for respiratory complications. Therefore, they need additional respiratory support. This study aimed to evaluate the effects of manual hyperinflation (MHI) on pulmonary function after weaning. This randomized clinical trial included 40 patients who had undergone abdominal surgery and were receiving oxygen via a T-piece. Patients were selected from the intensive care units (ICU) of two hospitals in Mashhad, Iran. The subjects were randomly allocated to intervention (MHI) and control groups. Patients in the MHI group were provided with three 20-minute MHI rounds using the Mapleson C, while the control group received routine cares. Tidal volume (Vt), Rapid Shallow Breathing Index (RSBI), and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio) were measured before the intervention, as well as 5 and 20 minutes after the intervention. Atelectasis prevalence was assessed before and 24 hours after the intervention. Data were analysed by SPSS software version 13. At baseline, there were no significant differences between the groups regarding Vt, RSBI, P/F ratio, and atelectasis rate. No significant difference was also found between the groups regarding atelectasis rate 24 hours after the intervention. However, at both posttests, Vt, RSBI, and P/F ratio in the MHI group were significantly better than the control group. In patients with artificial airway and spontaneous breathing, MHI improves pulmonary function.
腹部手术后，脱离机械通气并通过T形管接受氧疗的患者有发生呼吸并发症的风险。因此，他们需要额外的呼吸支持。本研究旨在评估手法肺过度充气（MHI）对撤机后肺功能的影响。这项随机临床试验纳入了40例接受腹部手术并通过T形管吸氧的患者。患者选自伊朗马什哈德两家医院的重症监护病房（ICU）。受试者被随机分配至干预组（MHI）和对照组。MHI组患者使用Mapleson C进行三轮每次20分钟的MHI，而对照组接受常规护理。在干预前以及干预后5分钟和20分钟测量潮气量（Vt）、快速浅呼吸指数（RSBI）以及动脉血氧分压与吸入氧分数之比（P/F比）。在干预前和干预后24小时评估肺不张发生率。数据采用SPSS 13.0软件进行分析。在基线时，两组在Vt、RSBI、P/F比和肺不张发生率方面无显著差异。干预后24小时两组在肺不张发生率方面也未发现显著差异。然而，在两次测试后，MHI组的Vt、RSBI和P/F比均显著优于对照组。对于有人工气道和自主呼吸的患者，MHI可改善肺功能。
