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.
