A survey of the use of ventilator hyperinflation in Australian tertiary intensive care units.

Objective: To ascertain the prevalence of use of ventilator hyperinflation (VHI) by physiotherapists practising in tertiary Australian intensive care units in the management of artificially ventilated patients, and whether standard protocols are in place in these facilities.

Design, Setting And Participants: A prospective, multicentre prevalence survey of 64 Australian hospitals with tertiary ICU facilities and physiotherapists. The cohort was compiled from details provided by the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation. Senior physiotherapists at participating sites completed a telephone questionnaire regarding the implementation of VHI at their facility.

Results: The response rate was 100%. Twenty-five facilities reported using VHI. There was broad agreement on the indications and contraindications for the technique and little difference in the dosage of VHI for the purpose of either sputum clearance or respiratory recruitment manoeuvre. The most common position used for treatment (71% of patients) was side lying with the affected side uppermost.

Conclusions: Our survey provides information on the nature and the extent of VHI utilisation by physiotherapists in Australian tertiary ICUs. These data can now be pooled to develop standardised evidence-based VHI protocols for both spontaneous and controlled ventilation modes.