Acute effects of manual lung hyperinflation on critically ill patients with traumatic brain injury / Mostafa Ali Atia Ali ; Supervised Awny Fouad Rahmy , Khaled Hussein Mohammad , Nagy Lowis Nassef

Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Internal Medicine

Background: Most of the hospitalized Patients with traumatic brain injury that are diagnosed are admitted to the intensive care unit (ICU). The main aim is to treat the injury, while the secondary goal is to minimize complications due to systemic hypoxemia, ischemia, and brain edema. Respiratory physiotherapy (RPT) is important in mechanically ventilated and intubated patients in ICU including patients who were admitted due to TBI. Manual hyperinflation (MH) is a chest physical therapy treatment used to enhance static pulmonary compliance and gas exchange in mechanically ventilated patients, with the aim of increasing alveolar oxygenation, reversing atelectasis, and mobilizing pulmonary secretions. Furthermore, this study helped to determine the acute effects of manual lung hyperinflation on patients with TBI who received mechanical ventilationin a comparison with traditional physical therapy techniques. Purpose: The aim of this study was to determine the acute effects of manual lung hyperinflation technique on patients with TBI who received mechanical ventilation. Subjects: Forty mechanically ventilated men patients with TBI admitted to the intensive care unit were sub divided into two equal groups randomly each one had 20 patients. Methods: Group A: (control group) include 20 men who received traditional chest physical therapy program which include vibro-compression maneuver, positioning, vibration, percussion and endotracheal suctioning for 20 minutes (10 minutes for each hemithorax). Group B: (experimental group) include 20 men who received manual lung hyperinflation maneuver and traditional chest physical therapy program. Results: There was statistical decrease post treatment in the PaCO2 in compare to pretreatment of both groups, the percent of change was 3.23% for group A and 9.78% for group B. In comparison between groups there was a statistical decrease of group B in the PaCO2 post treatment (p = 0.03) when compared with that of group A. For PaO2 and SaO2 there were significant increase of both groups when comparing post and pre treatment, the percent of change of (PaO2, SaO2) were (3.01%, 2.42%) respectively for group A and (8.24%, 4.95%) respectively for group B.

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