Group data for all outcomes for the experimental and control interventions are presented in Table 2, while individual data are presented in Table 3 (see eAddenda for Table 3). The weight of the aspirate was significantly

greater after physiotherapy in the experimental group, compared to baseline. However, the control group also showed Selleckchem LBH589 a small increase and overall the difference in effect between the experimental and control groups was not statistically significant, mean difference 0.4 g (95% CI −0.5 to 1.4). After the interventions, peak airway pressure did not significantly differ between the experimental and control groups. Tidal volume was significantly greater after physiotherapy in the experimental group, compared to baseline. However, the control group also showed a small increase and overall the difference in effect between the experimental and control groups was not statistically significant, mean difference 22 mL (95% CI −20 to 65). Similarly, dynamic compliance improved significantly after physiotherapy in the experimental group, but the change was not significantly greater

than in the control group, mean difference 1 cmH2O (95% CI −3 to 4). Heart rate increased significantly in both groups from baseline, but the between-group difference in this change was not statistically significant. The changes in respiratory rate were clinically unimportant, with no statistically significant difference between the groups in the change during the intervention, mean difference 2 breaths per minute (95% CI −4 to 1). GW-572016 in vivo The changes in mean arterial pressure and oxyhaemoglobin saturation were also not statistically significantly different between the experimental Metalloexopeptidase and control groups. Several authors have described the use of hyperinflation to prevent lung collapse, re-expand atelectatic areas, increase oxygenation, improve lung compliance and facilitate the movement of secretions from the small to the larger central airways (Denehy

1999, Savian et al 2006, Singer et al 1994). These effects appear to occur due to an increase in the tidal volume – generated by the hyperinflation that further expands the normal alveoli through the interdependence mechanism, which also re-expands collapsed alveoli (Stiller 2000). Lemes and colleagues (2009) provided data to support this using a randomised crossover trial. A ventilator-induced increase in pressure support improved the volume of secretions aspirated and the static compliance of the respiratory system. Although the difference in the intervention arms in both the Lemes study and the current study was the use of ventilator-induced hyperinflation, the other interventions applied to both groups differed. In the Lemes study, positioning was the only other intervention. In the current study, both groups received positioning and chest wall compression with vibrations.