Pressure Support During Chest Wall Compression

Increasing Pressure Support During Chest Wall Compression is Useful During Respiratory Therapy?

The purpose of this study is to compare two physiotherapy techniques: chest wall compression versus chest wall compression plus increase of 10 cmH2O in inspiratory pressure.

1. After being placed in the supine position in bed, with head angle elevation at 30°, patients were randomized to:group 1 (G1): chest wall compression for ten minutes in chest or group 2 (G2): chest wall compression plus increase of 10 cmH2O in IP in PSV for ten minutes in chest.
2. Clinical variables and APACHE II were registered.
3. Parameters analyzed at the beginning (1) and at the end (2) of the protocol were: variation of peak pressure (ΔPp=Pp2-Pp1),variation of tidal volume (ΔVT =VT2-VT1), variation of dynamic compliance (ΔCdyn= Cdyn2-Cdyn1).
4. The amount of variation of mucus secretion aspirated (ΔSa= Sa2-Sa1) at the end was also measured

Inclusion Criteria:

• Patients on mechanical ventilation over 48 hours
• With ventilatory drive
• Hemodynamically stable MAP> 60 mmHg
• With treatment of respiratory therapy

Exclusion Criteria:

• Contra indication of increased positive inspiratory pressure
• Peak pressure in the upper airway > 40 cmH2O
• Osteoporosis diagnosis
• Deny to participate in the study