Lung squeezing technique as a volume recruitment manoeuvre in correcting lung atelectasis for preterm infants on mechanical ventilation.

Abstract

by Ivor Wong (Nga Chung).Thesis (M.Phil.)--Chinese University of Hong Kong, 1998.Includes bibliographical references (leaves 114-120).Abstract also in Chinese.Chapter PART I --- INTRODUCTIONChapter 1. --- CHAPTER 1 BACKGROUND --- p.2Chapter 1.1 --- Objectives --- p.3Chapter 1.2 --- Effects of chest physiotherapy --- p.3Chapter 1.2.1 --- Aims of chest physiotherapy --- p.4Chapter 1.2.1.1 --- Mucus Removal --- p.4Chapter 1.2.1.2 --- Re-expansion of atelectatic lung --- p.9Chapter 1.2.2 --- Chest physiotherapy for neonates --- p.10Chapter 1.2.2.1 --- Pulmonary characteristics in neonates --- p.10Chapter 1.2.3 --- Chest physiotherapy for infants on mcchanical ventilation --- p.12Chapter 1.2.3.1 --- Conventional ventilation --- p.12Chapter 1.2.3.2 --- High frequency ventilation --- p.13Chapter 2. --- CHAPTER 2 NEONATAL CHEST PHYSIOTHERAPY --- p.15Chapter 2.1 --- Traditional physiotherapy means --- p.15Chapter 2.1.1 --- Percussion and Chest vibration --- p.15Chapter 2.1.2 --- Cup percussion (Cupping) --- p.16Chapter 2.1.3 --- Postural drainage (PD) --- p.16Chapter 2.1.4 --- Endotracheal Suctioning --- p.17Chapter 2.1.4.1 --- Adverse effects of endotracheal suctioning --- p.17Chapter 2.2 --- Possible Complications of chest physiotherapy --- p.20Chapter 2.2.1 --- Haemodynamic disturbances --- p.20Chapter 2.2.2 --- Fluctuation of Cerebral Perfusion --- p.21Chapter 2.2.3 --- Cystic brain lesions --- p.22Chapter 2.3 --- Modified manual techniques --- p.23Chapter 2.3.1 --- Theoretical model of lung squeezing technique --- p.23Chapter 2.3.2 --- Lung squeezing technique as a volume recruitment manoeuvre --- p.30Chapter 2.3.2.1 --- Squeezing phase of lung squeezing technique --- p.30Chapter 2.3.2.2 --- Release phase of lung squeezing technique --- p.31Chapter 3. --- CHAPTER 3 PHYSIOTHERAPY PRACTICE IN LOCAL NEONATAL ICU --- p.33Chapter 3.1 --- Current physiotherapy practice in Hong Kong Neonatal ICU settings --- p.33Chapter 3.1.1 --- Endotracheal suctioning protocol in Prince of Wales Hospital --- p.33Chapter 3.1.1.1 --- Suctioning Procedures --- p.34PART II MAIN STUDYChapter 4. --- CHAPTER 4 RESEARCH DESIGN --- p.37Chapter 4.1 --- Ethics --- p.37Chapter 4.2 --- Methods --- p.37Chapter 4.2.1 --- Pilot study --- p.37Chapter 4.2.2 --- Main study --- p.39Chapter 4.2.2.1 --- Hypothesis --- p.39Chapter 4.2.2.2 --- Study Design --- p.39Chapter 4.3 --- Methodology --- p.44Chapter 4.3.1 --- Treatment protocol --- p.44Chapter 4.3.1.1 --- Experimental Group protocol --- p.44Chapter 4.3.1.2 --- Control Group protocol --- p.44Chapter 4.3.2 --- Outcome Measure --- p.45Chapter 4.3.2.1 --- Chest X-ray --- p.45Chapter 4.3.2.2 --- Other Measurements --- p.45Chapter 4.3.3 --- Statistics --- p.48Chapter 5. --- CHAPTER 5 RESULTS --- p.50Chapter 5.2 --- Demographic Data --- p.50Chapter 5.3 --- Resolution of lung atelectasis --- p.56Chapter 5.3.1 --- Distribution of lung atelectasis --- p.56Chapter 5.3.2 --- First re-expansion of lung atelectasis --- p.59Chapter 5.3.3 --- Complete resolution of lung atelectasis --- p.62Chapter 5.3.3.1 --- Sites of rccurrencc of lung atelectasis --- p.65Chapter 5.4 --- Factors correlated with number of treatment sessions required to attain resolution of atelectasis --- p.68Chapter 5.5 --- Ventilator parameters changes --- p.73Chapter 5.6 --- Haemodynamic changes --- p.75Chapter 5.7 --- Arterial blood gas --- p.78Chapter 5.8 --- Other clinical outcome --- p.80Chapter 5.8.1 --- Bronchopulmonary dysplasia --- p.80Chapter 5.8.2 --- Intra-ventricular haemorrhage (IVH) --- p.82Chapter 5.8.3 --- Mortality rate --- p.86Chapter PART III --- EFFECTS OF LUNG SQUEEZING TECHNIQUE ON LUNG MECHANICSChapter 6. --- CHAPTER 6 LUNG MECHANICS STUDY FOR NEONATES --- p.88Chapter 6.1 --- Methods --- p.91Chapter 6.1.1 --- Statistical Analysis --- p.93Chapter 6.2 --- Results --- p.94Chapter PART IV --- DISCUSSION AND CONCLUSIONChapter 7. --- CHAPTER 7 SUMMARY AND CONCLUSION --- p.105Chapter PART V --- REFERENCEChapter 8. --- BIBLIOGRAPHY --- p.114Chapter PART VI --- GLOSSARYChapter PART VII --- APPENDICE