A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Vats, Neeraj
- Extubation Outcome after Spontaneous Breathing Trials with T-tube or Pressure Support Ventilation
Authors
1 Rajiv Gandhi Cancer Institute & Research Center, Sec. 5 Rohini, New Delhi
2 Faculty of Engineering Technology, IN
3 Faculty Of Applied Science, Manav Rachna International University, Faridabad, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 2 (2012), Pagination: 82-84Abstract
A 2-h T-tube trial of spontaneous breathing was used in selecting patients ready for extubation and discontinuation of mechanical ventilation. However, some doubt remains as to whether it is the most appropriate method of performing a spontaneous breathing trial. We carried out a prospective, randomized, study involving patients who had received mechanical ventilation for more than 48 h and who were considered by their physicians to be ready for weaning according to clinical criteria and standard weaning parameters. Patients were randomly assigned to undergo a 2-h trial of spontaneous breathing in one of two ways: with a T-tube system or with pressure support ventilation of 7 cm H2O. If a patient had signs of poor tolerance at any time during the trial, mechanical ventilation was reinstituted. Patients without these features at the end of the trial were extubated. Of the 20 patients assigned to the T-tube group, 15 successfully completed the trial and were extubated; 5 of them required reintubation. Of the 20 patients in the group receiving pressure support venti¬lation, 17 were extubated and 3 of them required reintubation. The percentage of patients failing the trial and ICU mortality was significantly higher when the T-tube was used. Clinical evolution during the trial was not different in patients reintubated and successfully extubated. Spontaneous breathing trials with pressure support or T-tube are suitable methods for successful dis¬continuation of ventilator support in patients without problems to resume spontaneous breathing.Keywords
Pressure Support Ventilation, T-Tube, Extubation Outcome, Spontaneous Breathing TrialsReferences
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- Effect of Deep Breathing Exercises and Incentive Spirometry in the Prevention of Post Operative Pulmonary Complications in the Patients of Cancer Esophagus undergoing Esophagectomy
Authors
1 Physiotherapist, Rajiv Gandhi Cancer Institute & Research Centre, Sec.- 5, Rohini, New Delhi 110 085, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 3, No 3 (2009), Pagination: 60-67Abstract
PurposeThe purpose of this study was 1) to evaluate the efficacy of deep breathing exercises over no chest physiotherapy 2) to evaluate the efficacy of incentive spirometry over no chest physiotherapy 3) to evaluate the efficacy of deep breathing exercises over incentive spirometry.
Inclusion criteria
Both sexes i.e. male&female were included in the study. Adults undergoing any type of esophagectomy for carcinoma of esophagus were also included because this population of adults represents with similar probable mechanisms for the development of pulmonary complications i.e. above the age of 18 years. Middle aged people& old people were also included in the study because they are more prone to develop post operative pulmonary complications after anesthesia.
Patients who gave their written consent for conducting this study on them. Patients who were not referred for physiotherapy even after esophagectomy were included in control group.
Only those patients who were assessed&examined preoperatively&for the initial 5 post operative days were included. Cooperative patients who followed the given instructions (such as the use of I.S.) properly.
Methods
Three groups of patients were made keeping 10 patients in each group. Group 1 patients were given deep breathing exercises manually, group 2 patients were asked to do incentive spirometry only& group 3 was control group. Deep breathing exercises were given in lying position with the head end of bed raised to 30-40 degrees. Incentive spirometry was given in sitting position with foot supported. The study was conducted in the post surgical unit of Rajiv Gandhi Cancer Institute&Research Center Sector 5 Rohini New Delhi -85 (India). Chest expansions at axilla, nipple&xiphisternum, Single breath count, Peak expiratory flow rate&oxygen saturation were the dependant variables.
Results
It was found that deep breathing exercise and Incentive spirometry are more effective than no chest physiotherapy. The results of the study further suggests that comparison of the two modalities i.e. Incentive spirometry&deep breathing exercises revealed no stastically significant difference among them.
Conclusion
The results of the study concluded that deep breathing exercises& incentive spiromety should be recommended as treatment modalities in the prevention of post operative pulmonary complications in the patients of carcinoma esophagus undergoing esophagectomy.More studies with greater sample population are required for the generalization of the results.
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