Efficacy and Ventilatory Responses to VHI in Atelectasis Patients

Efficacy and Ventilatory Responsiveness of Ventilator Hyperinflation Technique to Re-expand Lung Atelectasis and Improved Airway Clearance on Patients With Critical Trauma Who Are Intubated and Mechanically Ventilated

The purpose of this study include (1) To investigate the efficacy of ventilator hyperinflation technique to re-expand lung atelectasis on patients with critical trauma who intubated and mechanical ventilation in the intensive care unit, (2) To investigate the effectiveness of ventilator hyperinflation technique to improve airway clearance on patients with critical trauma in the intensive care unit, and (3) To explore the acute responses of ventilatory functions to ventilator hyperinflation technique on patients with critical trauma who intubated and mechanical ventilation in the intensive care unit.

Inclusion Criteria:

• Critical trauma patients with pulmonary complications who were intubated and mechanical ventilation and have a diagnosis of lobar atelectasis and/or plate-like atelectasis (atelectasis demonstrated on chest X-ray) will be considered for inclusion. For the sign of plate-like atelectasis will be persist on chest X-ray for 2 day
• The injuries may occur alone or combination of these injuries: 1) head injury, 2) chest injuries, including broken ribs, with or without hemothorax, pneumothorax and hemopneumothorax with intercostal chest drainage (ICD), 3) blunt abdominal, and 4) fracture of the limbs and/or spine.

Exclusion Criteria:

• acute respiratory distress syndrome (ARDS)
• acute lung injury (ALI)
• pulmonary contusion
• undrained pneumothorax, hemothorax, and hemopneumothorax
• bronchospasm
• pulmonary bullae/blebs
• lung tumors
• lung abscess
• haemoptysis
• mean arterial pressure (MAP) <70 mmHg
• positive end expiratory pressure (PEEP) >6 cmH2O
• heart rate (HR) >140 beats/min
• blood pressure (BP) <90/60 or >180/100 mmHg
• restlessness
• oxygen saturation (SpO2) <90%
• spontaneous respiratory rate (RR) >35 beats/min