Acute Effects of Manual Hyperinflation on Oxygenation and Hemodynamic Stability in Mechanically Ventilated Patients with Stroke-Associated Pneumonia

Background: Stroke-associated pneumonia (SAP) is a prevalent and serious consequence of acute stroke, often necessitating intubation and mechanical ventilation (MV). This condition significantly increases the hospital stay period and the risk of mortality.
Objective: To explore the acute impacts of manual hyperinflation on oxygenation and hemodynamic variables in MV patients with SAP.
Subjects and Methods: Forty mechanically ventilated patients (aged 50–70 years) diagnosed with acute SAP were recruited from the Stroke Intensive Care Unit (ICU) at El Kasr El Ainy Hospital. Patients were randomized and assigned to either a study group or a control group (n = 20 each). The study group underwent a single session of conventional chest physiotherapy (CPT) combined with manual hyperinflation, while the control group received conventional CPT alone. Arterial blood gases (PaO₂, PaCO₂), SpO₂, and Horowitz index, and hemodynamic variables (heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)) were measured instantly pre- and post-intervention to assess acute physiological responses.
Results: A statistically significant improvement in oxygen saturation (SpO₂) was indicated in the two groups following treatment (p < 0.05). No significant variations were observed in the residual respiratory parameters (PaO₂, PaCO₂, Horowitz index) in both groups. No significant variations were indicated in SBP or MAP in either group. However, the control group demonstrated a significant increase in HR and DBP. Between-group comparisons indicated no statistically significant differences across all measured variables.
Conclusion: Manual hyperinflation appears to be a safe and well-tolerated intervention in mechanically ventilated patients with SAP, with no immediate adverse effects on oxygenation or hemodynamic stability.