Efficacy of manual hyperinflation on arterial blood gases in patients with ventilator-associated pneumonia
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(2020) 25:4
Bulletin of Faculty of Physical Therapy
ORIGINAL RESEARCH ARTICLE
Open Access
Efficacy of manual hyperinflation on arterial blood gases in patients with ventilatorassociated pneumonia Basant H. Elrefaey1,2*
and Mohamed S. Zidan3
Abstract Background: Tracheal intubation exposes mechanically ventilated patients to serious pulmonary complications such as ventilator-associated pneumonia (VAP). This study was conducted to compare the efficacy of manual hyperinflation in supine versus lateral decubitus position on arterial blood gases (ABG) in patients with VAP. Fortytwo patients with ventilator-associated pneumonia with age range from 40 to 60 years were selected. They were randomly divided into two equal groups: group A who received manual hyperinflation from supine position and group B who received manual hyperinflation from lateral decubitus position (upper most affected). Both groups received respiratory physiotherapy. The patients received 2 sessions per day for 6 days. Outcome measures were arterial blood gases (PaO2, PaCO2, PaO2/FiO2, and SaO2). They were assessed before the 1st morning session (pre), at day 3 (post 1), and at day 6 (post 2). Results: After sessions, significant changes of measured variables (PaO2, PaCO2, PaO2/FiO2, and SaO2) were obtained in both groups (P < 0.05, in all variables) and by comparison between groups post-intervention; a significant difference was observed between both groups in measures of oxygenation in favor of group B (P < 0.05), whereas there was a non-significant difference in the PaC02 between both groups (post 1 P = 0.52 and post 2 P = 0.33). Conclusion: It was concluded that effect of the bag squeezing on arterial blood gases in patients with ventilatorassociated pneumonia from lateral decubitus position was more effective than from supine position. Trial registration: PACTR, PACTR201909817075549. Registered October 21, 2018—retrospectively registered https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4655 Keywords: Arterial blood gases, Manual hyperinflation, Position, Ventilator-associated pneumonia
Background Critically ill adults are often need a machine to help maintain their breathing. An increased risk of ventilatorassociated pneumonia (VAP) is one side effect of these machines [1]. Ventilator-associated pneumonia (VAP) can be defined as hospital-acquired pneumonia that * Correspondence: [email protected] 1 Department of Physical therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, 7 Ahmed Alzayate Street, Been Alsarayat, Giza 12111, Egypt 2 Department of Medical Rehabilitation, Faculty of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia Full list of author information is available at the end of the article
develops in intubated patients who have been receiving mechanical ventilation for at least 48 h [2]. In critically ill patients, VAP is associated with increased mortality, increased length of stay in the intensive care unit (ICU), and increased heal
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