effectiveness of mechanical vibrator for chest physiotherapy in ventilated head injury and spinal...
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ABSTRACTEffectiveness of Mechanical Vibrator for Chest Physiotherapy in Ventilated head & spinal injured patientsShiny Thomas, Deepak AgrawalDepartment of Neurosurgery, JPNA Trauma Centre, AIIMS, New DelhiBackground: Chest infection is one of the major factor in morbidity & mortality in ventilated head & spinal injured patients. It is hypothesized that mechanical vibrators may help in improving the quality & frequency of chest physiotherapy in these groups of patients.Aims & Objectives: To assess the decrease (if any) in chest infection rates & mortality in ventilated patients with head & spinal cord injury who received mechanical vibrator chest physiotherapy.Materials & methods: This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU. The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified tracheal culture) was collected over the two time periods. The ‘control’ group consisted of patients in whom data was retrospectively collected from January 2011 to March 2011 (before the introduction of Vibrators). The ‘test’ group consisted of patients in whom data was prospectively collected from April 2011 to June 2011 (following introduction of Vibrators). All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.Results: A total of 575 patients were evaluated in the study. Both Control & test groups were well matched with respect to [pTRANSCRIPT
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EFFECTIVENESS OF EFFECTIVENESS OF
MECHANICAL VIBRATOR MECHANICAL VIBRATOR FOR CHEST FOR CHEST
PHYSIOTHERAPY IN PHYSIOTHERAPY IN VENTILATED HEAD & VENTILATED HEAD &
SPINAL INJURED PATIENTSSPINAL INJURED PATIENTSMs. SHINY THOMASSTAFF NURSENEUROSURGERY ICUJPNATC, AIIMS New Delhi
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BACKGROUND
Chest infection is one of the major factor in morbidity & mortality in ventilated head & spinal injured patients.
Chest physiotherapy (CPT) has been used to improve airway clearance and treat lung collapse; however, the evidence to support its use has been conflicting.
It is hypothesized that mechanical vibrators may help in improving the quality & frequency of chest physiotherapy in these groups of patients.
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AIMS & OBJECTIVES
To assess the effects of active CPT techniques, such as percussion and vibration along with mechanical vibrator.
To assess the decrease (if any) in chest infection rates & mortality in ventilated patients with head & spinal cord injury who received mechanical vibrator chest physiotherapy.
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MATERIALS & METHODS
This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU.
The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified tracheal culture) was collected over the two time periods.
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MATERIALS & METHODS
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MATERIALS & METHODS
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MATERIALS & METHODS
All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.
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MODIFIED TRACHEAL CULTURE
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RESULTS A total of 575 numbers of patients were
evaluated in the study. Both Control & test groups were well matched with respect to the:
CONTROL GROUP
TEST GROUP
Number Of Head Injuries 234 206
Number of Spinal Injuries 74 64
Mean Age 30.75 years 31.9 years
Male: Female Ratio 89:13 77:13
Mean Admission GCS 9.6 9.9
Average Ventilator Days 7.46 days 7.9 days
Tracheal culture positivity (On surveillance)*
9.83% 15.18%
*p>0.05
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CONTROL GROUP TEST GROUP
VE
NT
ILA
TO
R
DA
YS
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8.3%
10.63%
15.84%
PE
RC
EN
TA
GE
OF
TR
AC
HE
AL
CU
LTU
RE
PO
SIT
IVE
P
AT
IEN
TS
CONTROL GROUP TEST GROUP
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RESULTS
The mortality was significantly lower in the test group 17.4% as compared to the control groups 27.21%.
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CONTROL GROUP TEST GROUP
MO
RT
ALI
TY
RA
TE
IN
PE
RC
EN
TA
GE
31.48%
15.84%
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CONCLUSIONS:
Use of mechanical vibrators by nurses for chest physiotherapy can improve outcomes & chest infection rates in ventilated head & spinal injury patients. We recommend their use as standard of care for ventilated patients.
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