| Title | The effect of positive end-expiratory pressure level on peak expiratory flow during manual hyperinflation. | | Author(s) | Savian C, Chan P, Paratz J | | Institution | Cardiopulmonary Research Unit, 4th Floor, Philip Block, Alfred Hospital, Melbourne, Victoria, Australia. Camila_Savian@hotmail.com | | Source | Anesth Analg 2005 Apr; 100(4):1112-6. | | MeSH | Adult
Double-Blind Method
Female
Humans
Lung Compliance
Male
Models, Anatomic
Peak Expiratory Flow Rate
Positive-Pressure Respiration
Respiratory Distress Syndrome, Adult
| | Abstract | Including positive end-expiratory pressure (PEEP) in the manual resuscitation bag (MRB) may render manual hyperinflation (MHI) ineffective as a secretion maneuver technique in mechanically ventilated patients. In this study we aimed to determine the effect of increased PEEP or decreased compliance on peak expiratory flow rate (PEF) during MHI. A blinded, randomized study was performed on a lung simulator by 10 physiotherapists experienced in MHI and intensive care practice. PEEP levels of 0-15 cm H(2)O, compliance levels of 0.05 and 0.02 L/cm H(2)O, and MRB type were randomized. The Mapleson-C MRB generated significantly higher PEF (P < 0.01, d = 2.72) when compared with the Laerdal MRB for all levels of PEEP. In normal compliance (0.05 L/cm H(2)O) there was a significant decrease in PEF (P < 0.01, d = 1.45) for a PEEP more than 10 cm H(2)O in the Mapleson-C circuit. The Laerdal MRB at PEEP levels of more than 10 cm H(2)O did not generate a PEF that is theoretically capable of producing two-phase gas-liquid flow and, consequently, mobilizing pulmonary secretions. If MHI is indicated as a result of mucous plugging, the Mapleson-C MRB may be the most effective method of secretion mobilization. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Randomized Controlled Trial
| | PubMed ID | 15781530 |
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