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潜在人群的肺扩张治疗:文献综述

Lung Expansion Therapy for the Potential Populations: A Literature Review.

作者信息

Sankarganesh A, Abathsagayam Kumaresan, Ravisankar Natesh Prabu, Alagingi Nityal Kumar

机构信息

Department of Physiotherapy, Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, IND.

Department of Physiotherapy, St John's Medical College Hospital, Bangalore, IND.

出版信息

Cureus. 2023 Nov 23;15(11):e49283. doi: 10.7759/cureus.49283. eCollection 2023 Nov.

Abstract

Secretion retention, atelectasis, and reduced lung compliance occur when endotracheal or tracheostomised patients cough ineffectively. There is a possibility of infection if the collapsed regions of the lungs are not reinflated. Therefore, to improve clinical outcomes, such as diaphragm mobility and thickness, lung volume, and thickness of the abdominal muscles, and decrease the length of hospitalizations, mechanical and manual techniques, such as balloon blowing exercises and incentive spirometer, are required. PubMed, Google Scholar, Pedro, Clinical Keys, Helinet, ProQuest, and Science Direct databases were used for the literature search considering the inclusion and exclusion criteria. The several manual and mechanical methods that were employed for lung expansion treatment for the potential populations are highlighted in this overview of the literature. Ten studies were considered in this review: five on balloon-blowing exercises, four on tracheostomy with incentive spirometry exercises, and one on incentive spirometry with balloon-blowing exercises. The effects were examined on individual outcomes that included rate of perceived exertion (RPE), diaphragm mobility, pulmonary function, volume of breath, length of hospitalization, and postoperative day complications. The structured protocols proved to be effective in improving lung expansion and pulmonary function for the potential population that involved healthy adults, noncritical COVID-19 adults, smokers, thoracotomy patients, and tracheostomised patients. The road to recovery is yet unexplored and underachieved because of the lack of evidence.

摘要

气管插管或气管切开患者咳嗽无效时会出现分泌物潴留、肺不张和肺顺应性降低。如果肺的萎陷区域不能复张,就有可能发生感染。因此,为了改善临床结局,如膈肌活动度和厚度、肺容量以及腹部肌肉厚度,并缩短住院时间,需要采用机械和手动技术,如吹气球练习和激励肺活量计。考虑到纳入和排除标准,使用PubMed、谷歌学术、Pedro、Clinical Keys、Helinet、ProQuest和Science Direct数据库进行文献检索。本综述强调了针对潜在人群采用的几种用于肺扩张治疗的手动和机械方法。本综述纳入了10项研究:5项关于吹气球练习,4项关于气管切开联合激励肺活量计练习,1项关于激励肺活量计联合吹气球练习。研究考察了这些方法对个体结局的影响,包括自觉用力程度(RPE)、膈肌活动度、肺功能、呼吸量、住院时间和术后并发症天数。结构化方案被证明对涉及健康成年人、非重症COVID-19成年人、吸烟者、开胸手术患者和气管切开患者的潜在人群改善肺扩张和肺功能有效。由于缺乏证据,康复之路尚未得到充分探索,成效也未达预期。

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