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Comparison of effects of manual versus ventilator hyperinflation on respiratory compliance and arterial blood gases in patients undergoing mitral valve replacement
Ahmed F, Shafeeq AM, Moiz JA, Geelani MA
Heart & Lung 2010 Sep-Oct;39(5):437-443
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare the effects of manual hyperinflation (MHI) and ventilator hyperinflation (VHI) delivered to completely sedated and paralyzed patients undergoing mitral valve replacement (MVR) while maintaining minute ventilation. METHODS: This was a randomized study with a 2-group, pre-test, post-test experimental design. Effects of hyperinflation were studied on static compliance (Cstat), dynamic compliance (Cdyn), oxygenation (PaO2:FiO2), partial pressure of carbon dioxide in arterial blood (PaCO2), and cologarithm of activity of dissolved hydrogen ions in arterial blood (pH). A sample of 30 patients in the immediate postoperative phase of MVR surgery were included in the study. RESULTS: No significant differences were found between the groups. Significant improvements were found in oxygenation at both 1 minute and 20 minutes after MHI, but only at 1 minute after VHI (p < 0.05). VHI led to improved Cdyn (p < 0.05). CONCLUSION: In the immediate postoperative phase of MVR, both techniques produced similar effects on respiratory compliance and oxygenation. MHI produced longer lasting improvements in oxygenation than VHI, whereas VHI produced better improvements in dynamic compliance. PaCO2 and pH were maintained by both.

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