Adding positive airway pressure to mobilisation and respiratory techniques hastens pleural drainage: a randomised trial.

Questions: In patients with a collection of fluid in the pleural space, do mobilisation and respiratory techniques: shorten the drainage period and length of hospital stay; improve respiratory function and oxygenation; and prevent pulmonary complications? Does the addition of positive airway pressure to this regimen further improve the effects?

Design: Randomised controlled trial with three intervention arms, concealed allocation, intention-to-treat analysis and blinded assessment.

Participants: One hundred and fifty-six inpatients with a fluid collection in the pleural space and with chest drainage in situ.

Intervention: Participants received usual care and were randomly assigned to: a control group that also received sham positive airway pressure (4 cmHO) only (Con); an experimental group that received incentive spirometry, airway clearance, mobilisation and the same sham positive pressure (Exp1); or an experimental group that received the Exp1 regimen except that the positive airway pressure was 15 cmHO (Exp2).