Document Detail


The effect of positive end-expiratory pressure level on peak expiratory flow during manual hyperinflation.
MedLine Citation:
PMID:  15781530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Camila Savian; Pamela Chan; Jennifer Paratz
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  100     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-22     Completed Date:  2005-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1112-6     Citation Subset:  AIM; IM    
Affiliation:
Cardiopulmonary Research Unit, 4th Floor, Philip Block, Alfred Hospital, Melbourne, Victoria, Australia. Camila_Savian@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Double-Blind Method
Female
Humans
Lung Compliance / physiology
Male
Models, Anatomic
Peak Expiratory Flow Rate / physiology*
Positive-Pressure Respiration / instrumentation,  methods*
Respiratory Distress Syndrome, Adult / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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