The effect of breath physiotherapeutic maneuvers on cerebral hemodynamics: a clinical trial

To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). The sample consisted of 20 patients with head...

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Published in:	Arquivos de neuro-psiquiatria Vol. 68; no. 4; pp. 567 - 572
Main Authors:	Cerqueira-Neto, Manoel Luiz de, Moura, Alvaro Vieira, Scola, Rosana Herminia, Aquim, Esperidião Elias, Rea-Neto, Alvaro, Oliveira, Mirela Cristine, Cerqueira, Telma Cristina Fontes
Format:	Journal Article
Language:	English
Published:	Brazil Academia Brasileira de Neurologia - ABNEURO 01-08-2010
Subjects:	Adult Blood Pressure - physiology Brain - blood supply Craniocerebral Trauma - physiopathology Craniocerebral Trauma - therapy Female Humans Intracranial Pressure - physiology Jugular Veins - physiology Male NEUROSCIENCES Oxygen - blood Prospective Studies PSYCHIATRY Respiratory Therapy - methods Valsalva Maneuver cérebro physical therapy respiratory brain respiratória fisioterapia
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Abstract	To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). The sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. The results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PjvO2 and SjvO2 and return to baseline of MBP and ICP 10 minutes after the end of suction. The respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralyzed.
AbstractList	OBJECTIVETo observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). METHODThe sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. RESULTSThe results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PjvO2 and SjvO2 and return to baseline of MBP and ICP 10 minutes after the end of suction. CONCLUSIONThe respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralyzed. OBJECTIVE: To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). METHOD: The sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. RESULTS: The results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PjvO2 and SjvO2 and return to baseline of MBP and ICP 10 minutes after the end of suction. CONCLUSION: The respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralyzed. OBJETIVO: Observar a repercussão das técnicas de fisioterapia respiratória na pressão arterial média (PAM), pressão intracraniana (PIC), pressão de perfusão cerebral (PPC), pressão venosa jugular de oxigênio (PjO2) e saturação venosa jugular de oxigênio (SjO2). MÉTODO: Foram incluídos no estudo 20 pacientes com traumatismo cranioencefálico. O protocolo consistiu na aplicação das manobras fisioterapêuticas de vibrocompressão (VBC), aumento de fluxo expiratório (AFE) e aspiração (ASP). RESULTADOS: Os resultados mostraram a manutenção das variáveis da hemodinâmica cerebral durante as manobras de VBC e AFE. Porém, em relação à ASP, houve uma elevação da PAM e PIC, com manutenção da PPC, PjO2 e SjO2 e retorno aos valores basais da PAM e PIC dez minutos após o final da aspiração. CONCLUSÃO: As manobras de fisioterapia respiratória (VBC, AFE) não promovem alterações sobre a hemodinâmica cerebral, ao contrário da ASP traqueal, em pacientes com traumatismo cranioencefálico grave, em ventilação mecânica, sedados e curarizados. To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). The sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. The results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PjvO2 and SjvO2 and return to baseline of MBP and ICP 10 minutes after the end of suction. The respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralyzed. OBJECTIVE: To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PJVO sub(2)) and jugular venous oxygen saturation (SJVO sub(2)). METHOD: The sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. RESULTS: The results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PJVO sub(2) and SJVO sub(2) and return to baseline of MBP and ICP 10 minutes after the end of suction. CONCLUSION: The respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe nead injury patients, mechanically ventilated, sedated and paralyzed. OBJECTIVE: To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), jugular venous oxygen pressure (PjvO2) and jugular venous oxygen saturation (SjvO2). METHOD: The sample consisted of 20 patients with head trauma. The protocol consisted of physiotherapy techniques application of vibrocompression (VBC), expiratory flow increase (EFI) and suction. RESULTS: The results show the maintenance on variables of cerebral hemodynamics during the techniques of VBC and EFI. However, in relation to suction, there was an increase of MBP, ICP, with maintenance of CPP, PjvO2 and SjvO2 and return to baseline of MBP and ICP 10 minutes after the end of suction. CONCLUSION: The respiratory physiotherapy techniques (VBC, EFI) do not promote cerebral hemodynamic repercussion, unlike suction, in severe head injury patients, mechanically ventilated, sedated and paralyzed.
Author	Rea-Neto, Alvaro Cerqueira-Neto, Manoel Luiz de Scola, Rosana Herminia Oliveira, Mirela Cristine Aquim, Esperidião Elias Moura, Alvaro Vieira Cerqueira, Telma Cristina Fontes
AuthorAffiliation	Universidade Federal de Sergipe Associação de Medicina Intensiva Brasileira Universidad de Buenos Aires Montreal Heart Institute Universidade Federal do Paraná
AuthorAffiliation_xml	– name: Universidade Federal de Sergipe – name: Montreal Heart Institute – name: Universidad de Buenos Aires – name: Universidade Federal do Paraná – name: Associação de Medicina Intensiva Brasileira
Author_xml	– sequence: 1 givenname: Manoel Luiz de surname: Cerqueira-Neto fullname: Cerqueira-Neto, Manoel Luiz de email: mlcerqueiraneto@gmail.com organization: Departament Medicine, University Federal of Paraná, Curitiba, PR, Brazil. mlcerqueiraneto@gmail.com – sequence: 2 givenname: Alvaro Vieira surname: Moura fullname: Moura, Alvaro Vieira – sequence: 3 givenname: Rosana Herminia surname: Scola fullname: Scola, Rosana Herminia – sequence: 4 givenname: Esperidião Elias surname: Aquim fullname: Aquim, Esperidião Elias – sequence: 5 givenname: Alvaro surname: Rea-Neto fullname: Rea-Neto, Alvaro – sequence: 6 givenname: Mirela Cristine surname: Oliveira fullname: Oliveira, Mirela Cristine – sequence: 7 givenname: Telma Cristina Fontes surname: Cerqueira fullname: Cerqueira, Telma Cristina Fontes
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/20730311$$D View this record in MEDLINE/PubMed
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References	Stiller K (ref4) 2000; 118 Thiesen RA (ref7) 2005; 63 Cruz J (ref21) 1993; 21 Gemma M (ref9) 2002; 14 Rudy EB (ref20) 1991; 20 Hsiang JK (ref15) 1994; 22 Pinaud M (ref19) 1991; 10 Gosselink R (ref3) 2008; 34 Ersson U (ref14) 1990; 34 Kerr ME (ref22) 1999; 27 David CM (ref2) 2004 Carvalho CRR (ref13) 2000 Knobel E (ref12) 2000 Oertel M (ref18) 2002; 81 Marik PE (ref1) 2002; 122 Irwin S (ref8) 1994 Oertel M (ref17) 2002; 97 Dean E (ref6) 1992; 101 Kerr ME (ref11) 1998; 7 Kerr ME (ref23) 1997; 46 Fortune J (ref10) 1994; 80 White PF (ref16) 1982; 57 Yilmazlar S (ref5) 2001; 7 Kerr, ME; Sereika, SM; Orndoff, P 1998; 7 Gemma, M; Tommasino, C; Cerri, M 2002; 14 Cruz, J 1993; 21 David, CM 2004 Irwin, S; Tecklin, JS 1994 Carvalho, CRR 2000 Oertel, M; Kelly, DF; Lee, JH 2002; 81 Rudy, EB; Turner, BS; Baun, M 1991; 20 Gosselink, R; Bott, J; Johnson, M 2008; 34 Knobel, E 2000 Fortune, J; Feustel, PJ; Weigle, CG 1994; 80 Oertel, M; Kelly, DF; Lee, JH 2002; 97 Thiesen, RA; Dragosavac, D; Roquejane, AC 2005; 63 Dean, E; Ross, J 1992; 101 Ersson, U; Carlson, H; Mellström, A 1990; 34 Hsiang, JK; Chesnut, RM; Crisp, CB 1994; 22 Pinaud, M; Lelausque, JN; Chetanneau, A 1991; 10 Marik, PE; Varon, J; Trask, T 2002; 122 Kerr, ME; Rudy, EB; Weber, BB 1997; 46 Yilmazlar, S; Kocaeli, H 2001; 7 Kerr, ME; Weber, BB; Sereika, SM 1999; 27 Stiller, K 2000; 118 White, PF; Schlobohm, RM; Pitts, LH 1982; 57
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Med contributor: fullname: Cruz, J – year: 2000 publication-title: Ventilação mecânica contributor: fullname: Carvalho, CRR – volume: 22 start-page: 1471 year: 1994 end-page: 1476 article-title: Early, routine paralysis for intracranial pressure control in severe head injury: is it necessary? publication-title: Crit Care Med contributor: fullname: Hsiang, JK; Chesnut, RM; Crisp, CB – start-page: 353 year: 1994 end-page: 354 publication-title: Fisioterapia cardiopulmonar contributor: fullname: Irwin, S; Tecklin, JS – volume: 34 start-page: 99 year: 1990 end-page: 103 article-title: Observations on intracranial dynamics during respiratory physiotherapy in unconscious neurosurgical patients publication-title: Acta Anaesthesiol Scand contributor: fullname: Ersson, U; Carlson, H; Mellström, A – year: 2004 publication-title: Medicina intensiva contributor: fullname: David, CM – year: 2000 publication-title: Condutas no paciente grave contributor: fullname: Knobel, E
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Snippet	To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral perfusion... OBJECTIVE: To observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral... OBJECTIVETo observe the repercussion of respiratory physiotherapy techniques on the mean arterial pressure (MBP), intracranial pressure (ICP), cerebral...
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SubjectTerms	Adult Blood Pressure - physiology Brain - blood supply Craniocerebral Trauma - physiopathology Craniocerebral Trauma - therapy Female Humans Intracranial Pressure - physiology Jugular Veins - physiology Male NEUROSCIENCES Oxygen - blood Prospective Studies PSYCHIATRY Respiratory Therapy - methods Valsalva Maneuver
Title	The effect of breath physiotherapeutic maneuvers on cerebral hemodynamics: a clinical trial
URI	https://www.ncbi.nlm.nih.gov/pubmed/20730311 https://search.proquest.com/docview/748971033 https://search.proquest.com/docview/858421484 http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2010000400017&lng=en&tlng=en
Volume	68
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