Effect of respiratory physical therapy maneuver on the cerebral hemodynamic

THESES

Effect of respiratory physical therapy maneuver on the cerebral hemodynamic (Abstract)^*. Thesis. Curitiba, 2006

Manoel Luiz de Cerqueira Neto^**

The respiratory physiotherapy has an extremely important and recognized role on the appropriate assistance to patients victims of head injury. Knowning the influence of respiratory system on the cerebral hemodynamic, this study proposes to observe the repercussion of respiratory physiotherapy techniques as Vibration and Compression, expiratory flow increase and endotracheal suction on the mean arterial pressure, intracranial pressure, cerebral perfusion pressure, jugular venous oxygen pressure and jugular venous oxygen saturation.

The sample consisted of 20 patients with head trauma, a Glasgow Coma Scale < 8, sedated, paralysed (Ramsay=6), intubated and mechanically ventilated, admitted in Adult Intensive Care Unit of Trabalhador Hospital in Curitiba-PR. There were 18 males (90%) and 2 females (10%), mean age 33.5 (±11.94) years and Apache II score 26.65 (±4.08).

The protocol consisted of physiotherapy techniques application of vibration and compression, expiratory flow increase (5 minutes in each chest wall) during 10 minutes for each technique. After, the suction was made, being preceded by instillation of 5 mL saline and 3 hyperinflations and hyperoxygenations. The variables were recorded after the end of each technique of vibration and compression, expiratory flow increase and suction, besides 10 minutes after the end of suction. Between each technique, happened a 5 minutes period of rest. The data were averaged statistically by ANOVA, Newman-Keuls and t Student tests. The normality condition of data were averaged by Kolmogorov-Smirnov. Values of p<0.05, indicate statistically significant. The results show the maintenance of mean arterial pressure, intracranial pressure, cerebral perfusion pressure, jugular venous oxygen pressure and jugular venous oxygen saturation during the techniques of vibration and compression, and expiratory flow increase. However, in relation to suction, there was an increase of mean arterial pressure, intracranial pressure, with maintenance of cerebral perfusion pressure, jugular venous oxygen pressure and jugular venous oxygen saturation and return to baseline mean arterial pressure and intracranial pressure 10 minutes after the end of suction.

Concluding, the respiratory physiotherapy techniques (vibration and compression, expiratory flow increase) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralysed.

Key words: physical therapy, respiratory, brain.

*

Efeito das manobras fisioterapêuticas respiratórias sobre a hemodinâmica cerebral (Resumo). Tese de Mestrado, Universidade Federal do Paraná (Área: Ciências da Saúde). Orientadores: Álvaro Vieira Moura, Rosana Herminia Scola e Esperidião Elias Aquim.

**

Address: Rua Oyapock, 90 / 62, 80050-450 Curitiba PR, Brasil.

Publication Dates

• Publication in this collection
  11 Apr 2008
• Date of issue
  Sept 2007