Manual Hyperinflation

Question 1

Aims of MHI

Answer 1

Mobilise peripheral secretions to central airways
Re-expand collapsed lungs
Improve oxygenation.
Improve static and dynamic compliance of lung
Reduce airway resistance
Prevent atelectasis

Question 2

Contraindications for MHI

Answer 2

Acute pulmonary oedema.
Bullae in patients with COPD or cystic fibrosis
Undrained pneumothorax, hemothorax, large pleural effusion or ICD with an air leak.
Bronchopleural fistula.
Obstructing airway tumor or lung tumor.
Intra-aortic balloon pump.
Extra ventricular drainage device.
Thoracic surgery with lung resection.
Presence of inflated gastric and oesophageal balloons.
Severe bronchospasm
Cardiac instability.
Frank haemoptysis
High frequency oscillatory ventilation

Question 3

Complications of MHI

Answer 3

Reduction in BP.
Reduced saturation.
Raised intracranial pressure.
Reduced respiratory drive