Biomedical subjects

S Patman

Publications and source records attributed to S Patman.

3 recordsLinked to original sources

PubMed2001

Manual hyperinflation: consistency and modification of the technique by physiotherapists.

BACKGROUND AND PURPOSE: The present study aimed to evaluate the consistency with which physiotherapists apply manual hyperinflation to a test lung using the Air-Viva-2 or Mapleson-B resuscitation circuit, and their ability to modify the technique as pulmonary characteristics change. METHOD: A quasi-experimental, randomized, repeated-measures design was used to study 16 volunteer physiotherapists performing manual hyperinflation to a test lung simulating three clinical situations. Each subject applied manual hyperinflation to the test lung for each simulation three times in one day using the resuscitation circuit that they would normally use in their clinical practice. Eight subjects used the Air-Viva-2 circuit and eight used the Mapleson-B circuit. Measurements of tidal volume (Vp), peak airway pressure (Paw) and fraction of delivered oxygen (FDO2) were recorded during each testing period. Inflation rate and minute volume were calculated. RESULTS: As compliance decreased and airway resistance increased, VT decreased and Paw increased. Of the eight subjects using the Air-Viva-2 circuit, only three subjects delivered greater than 0.80 FDO2. All subjects using the Mapleson-B circuit delivered greater than 0.85 FDO2. CONCLUSIONS: Subjects demonstrated good consistency in the application of manual hyperinflation for all three simulations and modified their technique appropriately as simulated pulmonary characteristics changed.

Female↗

PubMed2001

Physiotherapy following cardiac surgery: is it necessary during the intubation period?

This randomised controlled clinical trial investigated whether physiotherapy during the period of mechanical ventilation following cardiac surgery influenced subject outcomes. Two hundred and thirty-six subjects admitted to the intensive care unit (ICU) following elective or semi-urgent cardiac surgery were randomised to either a treatment group, which received physiotherapy during the intubated phase, or a control group where physiotherapy was commenced only once the subject was extubated. No significant differences between the two groups were detected for length of intubation period, length of ICU stay, length of hospital stay, maximal daily incentive spirometry values or the incidence of post-operative pulmonary complications. For individuals following routine uncomplicated cardiac surgery, the provision of physiotherapy interventions during the post-operative intubation period does not improve outcomes.

Adolescent↗

PubMed2000

Manual hyperinflation--effects on respiratory parameters.

BACKGROUND AND PURPOSE: Manual hyperinflation (MH) of the lungs is commonly used by physiotherapists in the treatment of intubated mechanically ventilated patients with the aim of increasing alveolar oxygenation, reversing atelectasis or mobilizing pulmonary secretions. However, the efficacy of MH, used in isolation, has not been clearly established. METHOD: This randomized, controlled trial investigated the effects of MH on lung compliance (CL), the arterial oxygen to fraction of inspired oxygen ratio (PaO2:FIO2) and the alveolar-arterial oxygen tension difference (A-a)PO2 in 100 medically stable, mechanically ventilated subjects who had undergone coronary artery surgery (CAS). Post-CAS subjects were used for this study as they constitute a large, homogeneous and accessible group. Subjects were randomized to either a control group (non-MH group) or to a treatment group (MH group) which received MH within four hours of surgery. RESULTS: After four minutes of MH there were significant improvements in CL, PaO2:FIO2 and (A-a)PO2 with values remaining above baseline measures at 60 min post-intervention. The mean improvement in CL was 6 ml/cmH2O (approximately 15%), 56 mmHg for PaO2:FIO2 (approximately 17%) and 29 mmHg for (A-a)PO2 (approximately 17%) immediately post-intervention. No significant changes in mean CL, PaO2:FIO2 or (A-a)PO2 were seen in the non-MH group. CONCLUSIONS: MH performed in the stable ventilated patient significantly increased CL and PaO2:FIO2 and decreased (A-a)PO2, but the clinical significance of this improvement is unclear. Further investigations are required to validate the findings of this study as well as to determine the therapeutic value of MH on patient outcome.

Adult↗