Effects of ventilator vs manual hyperinflation in adultsreceiving mechanical ventilation: a systematic review of randomised clinical trials

Anna Anderson, Jenny Alexanders, Charikleia Sinani, Stephen Hayes, Mark Forgarty

    Research output: Contribution to journalArticle

    Abstract

    AbstractBackground Ventilator hyperinflation (VHI) and manual hyperinflation (MHI) are thought to improve secretion clearance, atelectasis andoxygenation in adults receiving mechanical ventilation. However, to the authors’ knowledge, a systematic review of their relative effectivenesshas not been undertaken previously.

    Objective To determine whether VHI is more effective than MHI for the improvement of clinical outcomes in adults receiving mechanicalventilation.

    Data sources The electronic databases PubMed, Cochrane Library, CINHAL Plus, Wiley Online Library, ScienceDirect and PEDro weresearched from January 1993 until August 2013. OpenGrey, the metaRegister of Controlled Trials (mRCT) and the reference lists of allpotentially relevant studies were also searched.Study eligibility criteria Full English reports of randomised clinical trials comparing at least one effect of VHI and MHI in adults receivingmechanical ventilation.Study synthesis and appraisal Included studies were appraised using the Cochrane risk of bias tool. The findings were synthesised using apurely qualitative approach.

    Results All four included studies reported no significant differences in sputum wet weight, dynamic and static pulmonary compliance,oxygenation and cardiovascular stability between VHI and MHI.Limitations All of the included studies had considerable limitations related to the protocols, equipment, participants and outcome measures.Furthermore, the overall risk of bias was judged to be high for three studies and unclear for one study.

    Conclusion Only four studies, all of which had a high or unclear risk of bias and significant additional limitations, have compared the effectsof VHI and MHI in adults receiving mechanical ventilation. As such, further research in this area is clearly warranted.
    Original languageEnglish
    Article number101
    Pages (from-to)103-110
    Number of pages8
    JournalPhysiotherapy
    Volume101
    Issue number2
    DOIs
    Publication statusPublished - Jun 2015

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