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The effect of manual lung hyperinflation and postural drainage on pulmonary complications in mechanically ventilated

G Ntoumenopoulos1, A Gild, D J Cooper

  • 1Trauma Intensive Care Unit, Alfred Hospital, Melbourne, Victoria.

Anaesthesia and Intensive Care
|November 10, 1998
PubMed

Insights

Manual lung hyperinflation and postural drainage did not significantly reduce nosocomial pneumonia in ventilated trauma patients. A trend suggested potential benefits, warranting further investigation in larger studies.

Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Trauma Surgery

Background:

  • Nosocomial pneumonia is a significant complication in mechanically ventilated trauma patients.
  • Effective preventative strategies are crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To evaluate the efficacy of manual lung hyperinflation (MHI) and postural drainage in reducing nosocomial pneumonia incidence.
  • To assess the impact of these physiotherapy techniques on other outcome variables in mechanically ventilated trauma patients.

Main Methods:

  • A randomized controlled study involving 46 mechanically ventilated trauma patients.
  • Group A received physiotherapy (MHI and postural drainage); Group B served as the control.
  • Patients were withdrawn upon diagnosis or suspicion of nosocomial pneumonia.

Main Results:

  • No statistically significant difference in nosocomial pneumonia incidence between the physiotherapy and control groups.
  • Similar durations of mechanical ventilation and ICU stay in both groups.
  • No significant differences in pulmonary function (PaO2/FiO2 ratio) or ICU mortality were observed.

Conclusions:

  • Physiotherapy, as implemented, did not significantly reduce nosocomial pneumonia in this patient cohort.
  • A trend suggested a higher incidence in the control group, indicating a need for larger studies.
  • Further research with stricter diagnostic criteria in severely injured patients is recommended.

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