The effect of positive end-expiratory pressure level on peak expiratory flow during manual hyperinflation.

Abstract:

: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.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Savian C,Chan P,Paratz J

doi

10.1213/01.ANE.0000147505.98565.AC

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

1112-6

issue

4

eissn

0003-2999

issn

1526-7598

pii

100/4/1112

journal_volume

100

pub_type

临床试验,杂志文章,随机对照试验
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    pub_type: 临床试验,杂志文章,随机对照试验

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