A survey to assess the use of manual hyperinflation by physiotherapists in intensive care units

Objectives: The objectives were to determine whether or not
manual hyperinflation (MHT) is used as a treatment technique by
physiotherapists on respiratory compromised patients in intensive
care units (ICU).

Methods: A questionnaire was developed by according to
the available literature on the use of manual hyperinflation by
physiotherapists, Physiotherapists who practice cardiopulmonary
physiotherapy in ICUs of hospitals in the private sectors in Karachi
were identified then targeted for the study. The self-administered
questionnaire was then posted and emailed to the physiotherapists
identified for inclusion into the study.

Results: A total of 100 questionnaires were distributed among
physiotherapists. Of the 100 questionnaires distributed, the response
rate for the questionnaires was 80% The results showed 93%
physiotherapist use MHT in ICU. Maximum airway pressure used
by 78.8% physiotherapist is 20cmH2 O, 80% used manometer, 30%
use shaking as combination technique, 76.3% used percussion,
52.5% postural drainage and 48.8% used nebulization, 58.8%
give a treatment of MHT for 5 to 10 minutes. An indication of MHT
42.5% physiotherapist gives to increase oxygen saturation, 43% for
stimulation of a cough, 63.8% used for secretion dislodge,61.3%
used to increase lung compliance and 53.3% used to increase lung
volume. There is no physiotherapist who is post graduated in the
field of cardiopulmonary rehabilitation.

Conclusion: The survey of 80 physiotherapists, working in
ICUs of Karachi, indicated that MHI is a widely used treatment
technique. There is a general consensus regarding the benefits,
contraindications, and precautions regarding the use of MHI.
This has been shown to be in line with current studies conducted
in other countries. The survey does show that there is a need for
the development of a post-graduation program in cardiopulmonary
rehabilitation pertaining to the use of MHT.