BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant concern in critically ill patients, often leading to prolonged hospital stays and increased mortality. Manual Hyperinflation (MHI) is a physiotherapeutic intervention used to improve alveolar recruitment and secretion clearance in mechanically ventilated patients. However, there is limited data comparing the efficacy of MHI in different positions. OBJECTIVES: The study aims to compare the effects of MHI on arterial blood gases (ABG) in ventilated patients with pneumonia in supine versus lateral decubitus positions. METHODS: A total of 30 mechanically ventilated patients diagnosed with VAP were randomly assigned into two groups: Group A (n = 15) received MHI in a supine position, while Group B (n = 15) received MHI in a lateral decubitus position. MHI sessions were administered twice daily for six days. Pre- and post-intervention ABG parameters, including PaO2, PaCO2, SaO2, and PaO2/FiO2, were recorded and analysed using paired and unpaired t-tests. RESULTS: In the supine position, MHI resulted in minor, statistically non-significant improvements in PaO2 and SaO2 (p > 0.05). In the lateral decubitus position, significant improvements were observed in PaO2 (p < 0.05) and PaCO2 (p < 0.001). When comparing post-intervention ABG values between groups, PaO2 and PaCO2 were significantly better in the lateral decubitus position (p < 0.05), while SaO2 and PaO2/FiO2 showed non-significant improvements. CONCLUSIONS: MHI performed in a lateral decubitus position demonstrated superior efficacy in improving oxygenation and gas exchange compared to the supine position in VAP patients. This suggests that patient positioning should be a key consideration when administering MHI in critical care settings. Further studies with larger sample sizes are recommended to confirm these findings.

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