Cardiac Arrhythmias During Postural Drainage and Chest Percussion of Critically III Patients

Hammon, Willy E.; Connors, Alfred F.; McCaffree, D. R.

doi:10.1378/chest.102.6.1836

Cited by 44 publications

(18 citation statements)

References 23 publications

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“…The fact that we maintained optimum anesthesia throughout the experiments could have explained the lack of effects in our study, compared with those in other studies (4,(9)(10)(11)(12)(13)34). Indeed, the increase in Pra, CO, and/or PA wedge pressure (Ppaw) in some of these studies were attenuated by anesthetic, paralytic, and sedative agents (10,11,13).…”

Section: Discussionmentioning

confidence: 49%

“…Cardiac arrhythmias were reported after chest clapping (9). Physiotherapy, comprising 2 min of chest clapping and vibration in alternate side lying followed by airway suctioning, was shown to significantly increase heart rate (HR), systolic and mean arterial blood pressures (BPs), cardiac output (CO), and rate-pressure product with the extent of these effects markedly attenuated by anesthetic agents, muscle relaxants, sedatives, and pressure support ventilation (4,(10)(11)(12)(13).…”

mentioning

confidence: 99%

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Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model

Wong¹,

Paratz²,

Wilson³

et al. 2003

Journal of Applied Physiology

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Chest clapping, vibration, and shaking were studied in 10 physiotherapists who applied these techniques on an anesthetized animal model. Hemodynamic variables (such as heart rate, blood pressure, pulmonary artery pressure, and right atrial pressure) were measured during the application of these techniques to verify claims of adverse events. In addition, expired tidal volume and peak expiratory flow rate were measured to ascertain effects of these techniques. Physiotherapists in this study applied chest clapping at a rate of 6.2 +/- 0.9 Hz, vibration at 10.5 +/- 2.3 Hz, and shaking at 6.2 +/- 2.3 Hz. With the use of these rates, esophageal pressure swings of 8.8 +/- 5.0, 0.7 +/- 0.3, and 1.4 +/- 0.7 mmHg resulted from clapping, vibration, and shaking respectively. Variability in rates and "forces" generated by these techniques was <20% in average coefficients of variation. In addition, clinical experience accounted for 76% of the variance in vibration rate (P = 0.001). Cardiopulmonary physiotherapy experience and layers of towel used explained approximately 79% of the variance in clapping force (P = 0.004), whereas age and clinical experience explained >80% of variance in shaking force (P = 0.003). Application of these techniques by physiotherapists was found to have no significant effects on hemodynamic and most ventilatory variables in this study. From this study, we conclude that chest clapping, vibration, and shaking 1). can be consistently performed by physiotherapists; 2). are significantly related to physiotherapists' characteristics, particularly clinical experience; and 3). caused no significant hemodynamic effects.

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Section: Discussionmentioning

confidence: 49%

mentioning

confidence: 99%

Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model

Wong¹,

Paratz²,

Wilson³

et al. 2003

Journal of Applied Physiology

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“…11,13 Animals with pulmonary contusions often have some degree of hypoxia and should be supplemented with oxygen before and during these techniques. 11,13 Animals with pulmonary contusions often have some degree of hypoxia and should be supplemented with oxygen before and during these techniques.…”

Section: Vibrationmentioning

confidence: 99%

Physical Rehabilitation for the Critically Injured Veterinary Patient

Manning¹,

Vrbanac²

2014

Canine Rehabilitation and Physical Therapy

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“…Ventilator-associated pneumonia has been shown to increase mortality and morbidity in ventilated patients. (3,4) A number of treatment techniques (e.g., tracheobronchial suction, (5)(6)(7) gravity-assisted drainage or postural drainage, (8,9) manual hyperinflation (MH), (8) vibration and percussion (10) ) to encourage sputum clearance exists but they are not consistently effective (7,(11)(12)(13)(14)(15)(16) . No inhaled agents have been shown to consistently improve sputum clearance in intubated patients.…”

Section: Introductionmentioning

confidence: 99%

Method to Introduce Mannitol Powder to Intubated Patients to Improve Sputum Clearance

Tang

Chan

Rajbhandari

et al. 2011

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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Approximately 50 to 60% of the loaded dose of dry powder mannitol is delivered to the distal end of the tracheal tubes for both 4 × 40-mg and 4 × 80-mg capsules. The fine particle fraction (particles smaller than 5 μm) ranges from 20 to 31% of the loaded dose. Powder was emptied from each 40- and 80-mg capsule within 5 ± 1 puffs and 6 ± 1 puffs, respectively. This delivery system has been shown to consistently deliver a very high dose of powder with a favourable fine particle fraction to the distal end of a number of tracheal tubes. This has the potential for a number of clinical therapeutic applications in critically ill patients.

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Cardiac Arrhythmias During Postural Drainage and Chest Percussion of Critically III Patients

Cited by 44 publications

References 23 publications

Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model

Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model

Physical Rehabilitation for the Critically Injured Veterinary Patient

Method to Introduce Mannitol Powder to Intubated Patients to Improve Sputum Clearance

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