Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

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Monalisa Elizabeth
Chairul Yoel
Muhammad Ali
M. Sjabroeddin Loebis
Hasanul Arifin
Pertin Sianturi


Background Chest physiotherapy and suctioning are routine methods for airway clearance in mechanically-ventilated children. However, chest physiotherapy has not been confirmed to affect ventilation parameters, such as tidal volume (TV), peak inflation pressure (PIP), peak inspiratory flow (PIF), and peak expiratory flow (PEF), as well as blood gas analysis (BGA) values in pediatric intensive care unit (PICU) patients.

Objective To determine the efficacy of chest physiotherapy and suctioning vs. suctioning alone for improving the mechanical ventilation parameters and BGA.

Methods This randomized, single-blind, clinical trial was conducted from November 2012 to June 2013 in the PICU at Haji Adam Malik Hospital, Medan. A total of 40 mechanically-ventilated pediatric patients were enrolled and divided into either the chest physiotherapy and suctioning group (24 subjects) or the suctioning alone group (16 subjects). Subjects underwent treatment, followed by monitoring of their ventilation parameters and blood gas analyses. Data were analyzed by independent t-test and Mann-Whitney test.

Results Subjects comprised of 23 boys and 17 girls, with an age range of 1–204 months. After the respective treatments (chest physiotherapy and suctioning vs. suctioning alone), the ventilation parameters were as follows: median TV (60.0 vs. 56.5 mL, respectively; P=0.838), median PEF (10.4 vs. 10.8 I/s, respectively; P=0.838), median PIF (7.4 vs. 8.2 I/s, respectively; P=0.469), and mean PIP (17.3 vs. 15.6 cmH2O, respectively; P=0.23). The BGA values were: median pH (7.4 vs. 7.3, respectively; P=0.838), median pCO2 (38.4 vs. 36.2 mmHg, respectively; P=1.000), mean pO2 (136.6 vs. 139.2 mmHg, respectively; P=0.834), median HCO3 (20.4 vs. 22.7 mmol/L, respectively; P=0.594), median TCO2 (22.0 vs. 23.7 mmol/L, respectively; P=0.672), mean BE (-4.3 vs. -3.1 mmol/L, respectively; P=0.629), and median O2 saturation  (98.5 vs. 98.3 %, respectively; P=0.967).

Conclusion In mechanically-ventilated children in the PICU, ventilation parameters and BGA values are not significantly different between subjects who received both chest physiotherapy and suctioning and those who received suctioning alone.

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How to Cite
Elizabeth M, Yoel C, Ali M, Loebis M, Arifin H, Sianturi P. Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone. PI [Internet]. 9Jan.2017 [cited 29Jan.2020];56(5):285-0. Available from:
Received 2016-08-08
Accepted 2016-11-21
Published 2017-01-09


1. Mcllwaine M. Physiotherapy and airway clearance techniques and devices. Paediatr Respir Rev. 2006;7S1:S220-22.
2. Stiller K. Physiotherapy in intensive care: towards an evidence-based practice. Chest. 2000;118:1801-13.
3. Balcells Ramirez J, Lopez-Herce Cid J, Prevalence of mechanical ventilation in pediatric intensive care units in Spain. An Pediatr (Barc). 2004;61:533-41.
4. Gregson RK, Shannon H, Stocks J, Cole TJ, Peters MJ, Main E. The unique contribution of manual chest compression-vibrations to airflow during physiotherapy in sedated, fully ventilated children. Pediatr Crit Care Med. 2012;13:e97-102.
5. Paludo C, Zhang L, Lincho CS, Lemos DV, Real GG, Bergamin JA. Chest physical therapy for children hospitalised with acute pneumonia: a randomized controlled trial. Thorax. 2008;63:791-4.
6. Krause MF, Hoehn T. Chest physiotherapy in mechanically ventilated children: a review. Crit Care Med. 2000;28:1648-51.
7. Savian C, Chan P, Paratz J. The effect of positive end-expiratory pressure level on peak expiratory flow during manual hyperinflation. Anesth Analg. 2005;100:1112-6.
8. McCarren B, Alison J, Lansbury G. The use of vibration in public hospitals in Australia. Physiother Theory Practice. 2003;19:87-98.
9. McCool FD, Rosen MJ. Nonpharmacologic airmway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest. 2006;129:250-9S.
10. Mackenzie CF, Shin B, McAslan TC. Chest physiotherapy: the effect on arterial oxygenation. Anesth Analg. 1978;57:28-30.
11. McCarren B, Alison JA, Herbert RD. Vibration and its effect on the respiratory system. Aust J Physiother. 2006;52:39-43.
12. Argent AC, Morrow BM. What does chest physiotherapy do to sick infants and children? Intensive Care Med. 2004;30:1014-6.
13. Maxwell LJ, Ellis ER. Pattern of ventilation during manual hyperinflation performed by physiotherapists. Anaesthesia. 2007;62:27-33.
14. Gregson RK, Stocks J, Petley GW, Shannon H, Warner JO, Jagannathan R, et al. Simultaneous measurement of force and respiratory profiles during chest physiotherapy in ventilated children. Physiol Meas. 2007;28:1017-28.
15. Veronezi J, Vercelino R, Madruga C, Borba K, Kaminski P, Marostica PJ. Cystic fibrosis: comparison between conventional chest physical therapy and positive expiratory pressure in hospitalized patients. Rev Cienc Med. 2005;149:481-8.
16. Pattanshetty RB, Gaude GS. Effect of multimodality chest physiotherapy on the rate of recovery and prevention of complications in patients with mechanical ventilation: a prospective study in medical and surgical intensive care units. Indian J Med Sci. 2011;65:175-85.
17. Holloway R, Adams EB, Desai SD, Thambiran AK. Effect of chest physiotherapy on blood gases of neonates treated by intermittent positive pressure respiration. Thorax. 1969;24:421-6.