IJPR.2023.132

Type of Article: Case Report

Volume 11; Issue 3 (June 2023)

Page No.: 4537-4543

DOI: https://dx.doi.org/10.16965/ijpr.2023.132

Physiotherapy Management for Complete Right Lung Collapse- is there role of mechanical insufflation and exsufflation? -A Case Report

Bhakti Ambasana *¹, Harda shah ², Bharat Tiwari ³.

^*1MPT student (Transplantation rehabilitation), IKDRC-ITS College of Physiotherapy, college of Physiotherapy, civil hospital campus, Asarwa, Ahmedabad, Gujarat, India.

²Senior Lecturer PhD, IKDRC-ITS college of physiotherapy, college of Physiotherapy, civil hospital campus, Asarwa, Ahmedabad, Gujarat, India.

³I/C principal and senior lecturer, IKDRC-ITS College of Physiotherapy, civil hospital campus, Asarwa, Ahmedabad, Gujarat, India.

Corresponding Author: Dr. Bhakti Ambasana, MPT student (Transplantation rehabilitation), IKDRC-ITS College of Physiotherapy, college of physiotherapy, civil hospital campus, Asarwa, Ahmedabad, Gujarat, India. Contact no. 9824806249. E-Mail: bhakti221198@gmail.com

ABSTRACT

We are reporting, a case of 52 year old male, with obstructive uropathy who underwent cystolithotripsy surgery associated with chronic kidney disease presented with respiratory distress, tachypnea and hypoxia on 3^rd post-operative day. He was on maintenance hemodialysis. Examination revealed absent air-entry on right side, dull percussion note on right side and positive trail sign. Chest X-ray and HRCT showed complete collapse of right lung with ipsilateral shift of trachea with mediastinum. Conventional physiotherapy postural drainage, breathing exercises, active cycle of breathing technique, forced expiratory techniques, spirometry, nebulization given for a day, no improvement seen because patient had strong cough reflex but unable to expectorate; any effort to cough caused more distress and breathing difficulty. Mechanical insufflation-exsufflation, a therapy in which the device which inflates the lungs(Insufflation pressure start at 15-20 cmH2O and increase to give an inspiration to total lung capacity, last for 2 second) followed by an immediate and abrupt change to negative pressure (exsufflation pressure same as the insufflation, then increase up to 10–20cmH2O, held for 3-6 second), which produces rapid exhalation, simulates cough and thus moves secretions cephaladly. Thus device helps patient cough out effectively. Lung collapse resolved within 1 day, regular physiotherapy was given to prevent recurrent lung collapse until discharge, X-ray and auscultation findings and oxygen saturation improved. It concludes, successful utilization of chest physiotherapy and mechanical insufflators-exsufflators aids in the resolution of lung collapse in an urgent situation.

Keywords: Mechanical insufflator-exsufflator, Atelectasis, chronic kidney disease, cystolithotripsy.

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Cite this article: Bhakti Ambasana, Harda shah, Bharat Tiwari. Physiotherapy Management for Complete Right Lung Collapse- is there role of mechanical insufflation and exsufflation? -A Case Report. Int J Physiother Res 2023;11(3):4537-4543. DOI: 10.16965/ijpr.2023.132

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