RT Journal Article
SR Electronic
T1 Effects of Manual Rib Cage Compressions on Mucus Clearance in Mechanically Ventilated Pigs
JF Respiratory Care
FD American Association for Respiratory Care
SP 1135
OP 1140
DO 10.4187/respcare.07249
VO 65
IS 8
A1 Ouchi, Akira
A1 Sakuramoto, Hideaki
A1 Unoki, Takeshi
A1 Yoshino, Yasuyo
A1 Hosino, Haruhiko
A1 Koyama, Yasuaki
A1 Enomoto, Yuki
A1 Shimojo, Nobutake
A1 Mizutani, Taro
A1 Inoue, Yoshiaki
YR 2020
UL http://rc.rcjournal.com/content/65/8/1135.abstract
AB BACKGROUND: Manual rib cage compression is a chest physiotherapy technique routinely used in clinical practice. However, scientific evidence remains scarce on the effects of manual rib cage compression on airway clearance and oxygenation in mechanically ventilated patients.METHODS: Anesthetized pigs were intubated via the trachea and mechanically ventilated. To create atelectasis, artificial mucus was infused into the airway. Each pig was randomly assigned to 1 of 2 groups: closed suctioning alone (control group, 7 pigs), or manual rib cage compression combined with closed suctioning (manual rib cage compression group, 8 pigs). Hard and brief rib cage compression synchronized with early expiratory phase was tested. Mucus clearance and oxygenation were assessed after the intervention. Sequential changes of hemodynamics were assessed after the intervention.RESULTS: During hard manual rib cage compression, the mean ± SD peak expiratory flow increased to 44 ± 7 L/min compared with 31 ± 7 L/min without treatment (P < .001). Manual rib cage compression combined with endotracheal suctioning increased mucus clearance compared with closed suctioning alone (mucus amounts, 5.5 [3.4–9.4] g vs 0.7 [0.5–2.0] g; P = .004); however, it did not improve gas exchange and radiologic findings. There were no significant differences in hemodynamic variables between the 2 groups.CONCLUSIONS: Our findings indicated that hard and brief manual rib cage compression combined with closed suctioning was safe and led to improvement of mucus clearance; however, no effectiveness was confirmed with regard to oxygenation and ventilation.