Effect of expiratory ribcage compression technique and respiratory neurofacilitatory techniques on lung function in mechanically ventilated patients: a review of literature

Abstract

Respiratory conditions pose significant challenges in critical care settings, particularly in managing patients who require mechanical ventilation in the intensive care unit (ICU). While mechanical ventilation is crucial for saving lives, it can also lead to complications such as impaired lung function and secretion retention. To address these issues, various physiotherapy techniques have been employed to enhance respiratory function and promote mucus clearance. These include manual techniques like expiratory rib cage compression (ERCC) and respiratory neuro-facilitative methods such as intercostal stretch (ICS), anterior basal lift (ABL), proprioceptive neuromuscular facilitation (PNF), and vertebral pressure (VP). A literature review was conducted, analyzing studies that evaluated the effectiveness of ERCC, ICS, ABL, PNF, and VP in patients on mechanical ventilation. The review focused on outcomes related to respiratory function, lung expansion, oxygen saturation, mucus clearance, and overall patient health. The data were collected, analyzed, and compared across different studies to assess the relative effectiveness of each technique. The review found that ICS, ABL, and VP significantly improved lung expansion and rib cage mobility, while PNF techniques, such as rhythmic initiation, enhanced respiratory muscle coordination and oxygen saturation. ERCC was particularly effective in promoting mucus clearance and improving respiratory mechanics in mechanically ventilated patients. The findings highlight the importance of personalized physiotherapy strategies in optimizing respiratory care for critically ill patients. Further research is recommended to refine these techniques and develop standardized protocols for their application in clinical practice.