Safety and Effectiveness of Breath Stacking in Management of Persons with Acute Atelectasis

Abstract

Purpose: Atelectasis is frequently observed in acutely ill, intubated patients. One technique for management of the secretion retention is breath stacking, a two-part procedure comprising manual hyperinflation using a resuscitation bag and a one-way valve, followed by a manually assisted cough and suctioning as required. The purpose of this preliminary study was to compare the safety and effectiveness of breath stacking combined with conventional physiotherapy (PT) care (PT composed of modified postural drainage combined with percussions, vibrations and suctioning) compared with PT alone in the management of acute atelectasis. Method: Intubated subjects with acute (, 72 hours) major atelectasis (lobar or greater) were randomized to receive breath stacking plus PT or PT alone twice daily for 3 days. Results: Twenty subjects entered the study. There was no difference between the groups on chest radiograph (p 5 .94) or volume of sputum suctioned. There were no respiratory or cardiac complications. Conclusions: Although this study had less than adequate power, the results demonstrated that breath stacking plus PT was no more effective than conventional PT alone for these patients. Breath stacking was a safe procedure as practised in this study.