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  • A comparison of the effects of manual hyperinflation and ventilator hyperinflation on restoring end-expiratory lung volume after endotracheal suctioning: A pilot physiologic study

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    Author(s)
    Linnane, Matthew P
    Caruana, Lawrence R
    Tronstad, Oystein
    Corley, Amanda
    Spooner, Amy J
    Barnett, Adrian G
    Thomas, Peter J
    Walsh, James R
    Griffith University Author(s)
    Corley, Amanda
    Walsh, James R.
    Year published
    2019
    Metadata
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    Abstract
    Purpose: Endotracheal suctioning (ES) of mechanically ventilated patients decreases end-expiratory lung volume (EELV). Manual hyperinflation (MHI) and ventilator hyperinflation (VHI) may restore EELV post-ES but it remains unknown which method is most effective. The primary aim was to compare the efficacy of MHI and VHI in restoring EELV post-ES. Materials and methods: ES was performed on mechanically ventilated intensive care patients, followed by MHI or VHI, in a randomised crossover design. The washout period between interventions was 1 h. End-expiratory lung impedance (EELI), measured by electrical impedance tomography, ...
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    Purpose: Endotracheal suctioning (ES) of mechanically ventilated patients decreases end-expiratory lung volume (EELV). Manual hyperinflation (MHI) and ventilator hyperinflation (VHI) may restore EELV post-ES but it remains unknown which method is most effective. The primary aim was to compare the efficacy of MHI and VHI in restoring EELV post-ES. Materials and methods: ES was performed on mechanically ventilated intensive care patients, followed by MHI or VHI, in a randomised crossover design. The washout period between interventions was 1 h. End-expiratory lung impedance (EELI), measured by electrical impedance tomography, was recorded at baseline, during ES, during hyperinflation and 1, 5, 15 and 30 min post-hyperinflation. Results: Nine participants were studied. ES decreased EELI by 1672z (95% CI, 1204 to 2140) from baseline. From baseline, MHI increased EELI by 1154z (95% CI, 977 to 1330) while VHI increased EELI by 769z (95% CI, 457 to 1080). Five minutes post-VHI, EELI remained 528z (95% CI, 4 to 1053) above baseline. Fifteen minutes post-MHI, EELI remained 351z (95% CI, 111 to 592) above baseline. At subsequent time-points, EELI returned to baseline. Conclusions: MHI and VHI effectively restore EELV above baseline post-ES and should be considered post suctioning.
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    Journal Title
    Journal of Critical Care
    Volume
    49
    DOI
    https://doi.org/10.1016/j.jcrc.2018.10.015
    Copyright Statement
    © 2019 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Clinical Sciences
    Nursing
    Science & Technology
    Life Sciences & Biomedicine
    Critical Care Medicine
    General & Internal Medicine
    Ventilator hyperinflation
    Publication URI
    http://hdl.handle.net/10072/386766
    Collection
    • Journal articles

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