STUDY OBJECTIVES: To investigate the effect of manual hyperinflation (MH) in patients with atelectasis associated with ventilation support. DESIGN: Patients were randomized to either an experimental group or a control group. SETTING: Pulmonary ICUs from two hospitals. PATIENTS: Twenty-three patients with atelectasis associated with ventilation support. INTERVENTIONS: The MH technique was at a rate of 8 to 13 breaths/min for a period of 20 min each session, three times per day for 5 days. The control group received their standard prescribed mechanical ventilation without supplemental MH. Sputum contents (wet/dry weight ratio, viscosity), respiratory system capacity (spontaneous tidal volume (Vt), maximal inspiratory pressure, rapid shallow breathing index (f/Vt), chest radiograph signs, and PaO2/fraction of inspired oxygen (FiO2)) were measured just prior to the MH at day 0 as baseline, and at day 3 and day 6 of the study. MEASUREMENTS AND RESULTS: There were significant improvements in scores over the 6-day study in the experimental group compared to the control group in spontaneous Vt (p = 0.035) and chest radiograph signs (p = 0.040), and a trend toward improvement of f/Vt (p = 0.066) and PaO2/FiO2 (p = 0.061) after adjustment for covariates. Other outcome variables did not differ significantly between the experimental and control groups. CONCLUSIONS: MH performed on patients with atelectasis from ventilation support significantly improved alveolar recruitment.

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