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

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.

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.

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.

MATERIALS & METHODS

MATERIALS & METHODS

MATERIALS & METHODS

All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.

MODIFIED TRACHEAL CULTURE

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

CONTROL GROUP TEST GROUP

VE

NT

ILA

TO

R

DA

YS

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

RESULTS

The mortality was significantly lower in the test group 17.4% as compared to the control groups 27.21%.

CONTROL GROUP TEST GROUP

MO

RT

ALI

TY

RA

TE

IN

PE

RC

EN

TA

GE

31.48%

15.84%

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.