• DaiWai M Olson, Suzanne M Thoyre, Stacey N Bennett, Joanna B Stoner, and Carmelo Graffagnino.
• Duke University Medical Center, Durham, North Carolina, USA. Olson006@mc.duke.edu
• Am. J. Crit. Care. 2009 Jul 1;18(4):330-5.

BackgroundTreatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdotal evidence indicates that physical stimulation increases intracranial pressure and should be avoided in patients at risk of intracranial hypertension.ObjectivesTo explore the safety of performing chest percussion for patients at high risk for intracranial hypertension.MethodsA total of 28 patients with at least 1 documented episode of intracranial hypertension who were having intracranial pressure monitored were studied in a prospective randomized control trial. Patients were randomly assigned to either the control group (no chest percussion) or the intervention group (10 minutes of chest percussion at noon). Intracranial pressure was recorded once a minute before, during, and after the intervention.ResultsMean intracranial pressures for the control group before, during, and after the study period (14.4, 15.0, and 15.9 mm Hg, respectively) did not differ significantly from pressures in the intervention group (13.6, 13.7, and 14.2 mm Hg, respectively).ConclusionsMechanical chest percussion may be a safe intervention for nurses to use on neurologically injured patients who are at risk for intracranial hypertension.

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