The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

CHANGE IN LUNG MECHANICS DURING CHEST PHYSICAL THERAPY TECHNIQUES

Yoshihiro Uzawa RPT, Yasunari Yamaguchi RPT, Norihiro Kaneko MD. Kameda Medical Center, Kamogawa, Chiba, Japan. Tetsuo Miyagawa RPT,RCET,RRT. Showa Univ. Yokohama, Kanagawa, Japan.

Introduction: Chest physical therapy techniques are commonly performed for patients to enhance secretion clearance. However, the effect of these techniques in lung mechanics has not been studied. The purpose of this study was to evaluate the change in lung mechanics, especially expiration flow rate, during application of the chest physical therapy techniques. Method: The subjects were 9 patients with acute respiratory failure who were 68.6 ± 8.8 years old, and all patients were intubated. We performed 3 techniques (squeezing, vibration and percussion), which were done in a standard fashion. We measured peak expiratory flow rate (PEFR) by a Bicore CP100 monitor (Bicore, Irvine, Ca). Tube with esophageal catheter was inserted to some subjects to observe esophageal pressure and a pressure-volume curve (P- V curve). Base line was measured on a lateral position and then all three techniques, in a randomized order, were applied for 5mins each, to subjects in the same position. Between techniques subjects took a rest to bring PEFR back to the base line. Statistical analysis was done using ANOVA. Results: There was significant difference in PEFR between squeezing and the other techniques (p < 0.01). However, there was no difference between vibration and percussion. P-V curve changed during squeezing. V_{T} tended to increase during application of the squeezing. Conclusion: The results of this study suggest that squeezing is the most effective technique, among the three performed in this study, to increase PEFR and V_{T}. It is helpful to remove secretion for patients who can not cough voluntarily.

OF-97-168

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