Cardiorespiratory consequences of expiratory chest wall compression during mechanical ventilation and severe hyperinflation

Effects of Manual Rib Cage Compressions on Expiratory Flow and Mucus Clearance During Mechanical Ventilation*

“…We found a significant impairment in CO sustained following the end of the maneuver. Previous studies have shown similar results in an animal model of severe pulmonary hyperinflation (26), and in patients recovering from severe asthma (27) mainly due to the fall in venous return; our recent evidence demonstrates that soft MRCC could exert deleterious effects even in healthy lungs. Finally, the mechanical ventilator is likely to autotrigger during soft MRCC; hence, trigger sensitivity should be set accordingly.…”

External Chest Compression in the Management of Acute Severe Asthma—A Technique in Search of Evidence

“…The technique was studied in experimental and a clinical studies by Van de Tow and colleagues. The dog study 3 mentioned previously was performed in a hyperinflated, mechanically ventilated model, and demonstrated that rib cage compression resulted in exacerbation of a decreased cardiac output, which was attenuated by abdominal compression. Both abdominal and chest compression increased mean expiratory pleural pressure and reduced expiratory lung volume.…”

“…In the experimental studies of chest compression in hyperventilated dog model, it was shown that abdominal compression was as effective as chest compression in reducing end expiratory volume, but with less effect on cardiac function. 3…”

Mechanical Ventilation Management During Mechanical Chest Compressions

“…Excessive PEEP may worsen the outcome of cardiopulmonary resuscitation, but more evidence is required to establish the validity of this statement. For instance, Van der Touw et al 23 pointed out that, during conditions of hyperinflation, the increase in intrathoracic pressure resulting from chest compressions reduces the cardiac output and the mean arterial pressure.…”