• Pricila Mara Novais de Oliveira, Armando Augusto Almeida-Junior, Celize Cruz Bresciani Almeida, Maria Angela Gonçalves de Oliveira Ribeiro, and José Dirceu Ribeiro.
• Graduate Program of Child and Adolescent Health, Department of Pediatrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. pricilaufjf@yahoo.com.br
• Resp Care. 2012 Nov 1;57(11):1908-13.

BackgroundManual hyperinflation (MH) is used to improve mucociliary clearance and alveolar expansion in mechanically ventilated patients. Despite the popularity of MH, studies with adults have shown considerable variability in the results from its use. This study assessed if professional training on the application of MH influences its performance.MethodsAn experimental study was conducted with physiotherapists, including 11 with previous professional experience (experienced) and 11 without previous experience (inexperienced). They applied MH in a test lung model using self-inflating bags in 2 sizes (infant and pediatric) from 3 manufacturers (Hudson, Laerdal, and JG Moriya). The test lung simulated the lung mechanics of a newborn and a pediatric patient in 2 different clinical situations: at normal and reduced compliance. The professionals were instructed to perform MH as described in the literature. Measurements of inspiratory volume, peak inspiratory pressure, peak inspiratory flow, and peak expiratory flow were recorded using a pneumotachograph in each condition.ResultsThe delivered peak inspiratory flow was higher in the experienced group (P = .03) than in the inexperienced group. This result was observed in both neonatal and pediatric self-inflating bags. There was no difference in the parameters delivered between the experienced and inexperienced groups.ConclusionsThe experienced and inexperienced groups were similar in their overall MH performance; the only difference was the observation of the highest PIF in the results from the experienced group.

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