Clinical Study
What Is the Best Pulmonary Physiotherapy Method in ICU?
Ufuk Kuyrukluyildiz,
1
Orhan Binici,
1
Elke Kupeli,
1
Nurel Erturk,
2
BarJG Gulhan,
3
Fethi Akyol,
1
Adalet Ozcicek,
4
Didem Onk,
1
and Guldane Karabakan
5
1
Department of Anesthesiology and Reanimation, Faculty of Medicine, Erzincan University, 24100 Erzincan, Turkey
2
Physiotherapy and Rehabilitation Clinic, Mengucek Gazi Education and Training Hospital, Erzincan, Turkey
3
Department of Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
4
Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey
5
Department of Anesthesiology and Reanimation, Faculty of Medicine, Mersin University, Mersin, Turkey
Correspondence should be addressed to Ufuk Kuyrukluyildiz; drufuk2001@gmail.com
Received 11 January 2016; Revised 2 April 2016; Accepted 6 April 2016
Academic Editor: Lorenzo Spaggiari
Copyright © 2016 Ufuk Kuyrukluyildiz et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objective. Effects of high frequency chest wall oscillation technique were investigated on intubated ICU patients. Background. irty
intubated patients were included in the study. e control group ( = 15) received routine pulmonary rehabilitation technique.
In addition to the pulmonary rehabilitation technique, the study group ( = 15) was given high frequency chest wall oscillation
(HFCWO). APACHE II, dry sputum weight, lung collapse index, and blood gas values were measured at 24th, 48th, and 72nd hours
and endotracheal aspirate culture was studied at initial and 72nd hour. e days of ventilation and days in ICU were evaluated.
Results. ere is no significant difference between APACHE II scores of groups. e dry sputum weights increased in the study
group at 72nd hour ( = 0.001). e lung collapse index decreased in study group at 48th ( = 0.003) and 72nd hours (<
0.001). e PO
2
levels increased in the study group at 72nd hour ( = 0.015). e culture positivity at 72nd hour was decreased
to 20%. e days of ventilation and staying in ICU did not differ between the groups. Conclusions. Although HFCWO is very
expensive equipment, combined technique may prevent the development of lung atelectasis or hospital-acquired pneumonia more
than routine pulmonary rehabilitation. It does not change intubated period and length of stay in ICU. However, more further
controlled clinical studies are needed to use it in ICU.
1. Introduction
Pulmonary complications are the most common causes of
morbidity and mortality in ICU patients [1]. Intensive care
unit patients are usually intubated and monitored through
mechanical ventilator. is makes it difficult to clean the
airway passages of these patients [2]. e airway secretions,
which cannot be excreted, have caused the transient mucocil-
iary dysfunction and inability to cough. As a result of these
secretions, intrapulmonary shunts can be developed and
tidal volume has reduced. Finally complications extending to
atelectasis, bronchopulmonary inflammation and infections,
pneumonia, respiratory arrest, and even death can occur
accordingly [3–5]. Several techniques and devices can be used
in order to mobilize the secretions, make the coughing effec-
tive, and improve cleaning of the airway. e conventional
chest physiotherapy is a method including postural drainage,
position, and percussion technique [6]. Applied for many
years and supporting the airway clearance, this method of
airway clearance is human-dependent and frequency and
duration of activity vary according to the practitioners.
Likewise it has been reported that conventional method is
labor intensive, with relatively low percentage of therapy and
discomfort for patients [7].
High frequency chest wall oscillation (HFCWO) has been
used for a long time on the treatment of chronic conditions
such as cystic fibrosis, bronchiectasis, and neuromotor-
neuromuscular disorders. HFCWO loosens the mucus
adherent to the bronchial airway and creates a cough-like
effect [8, 9]. It has an important advantage like making stan-
dard mechanical therapy without dependent practitioners
[10]. HFCWO has been typically applied for a certain time
Hindawi Publishing Corporation
Canadian Respiratory Journal
Volume 2016, Article ID 4752467, 5 pages
http://dx.doi.org/10.1155/2016/4752467