Effect of cough assist device on blood gasses and period of mechanical ventilator for pneumonic children with general hypotonia

BACKGROUND: Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. RESULTS: This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO(2), and HCO(3) post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO(2), and HCO(3) in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO(2), and HCO(3) respectively. There was a significant increase in PaO(2) post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO(2) in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO(2), and HCO(3) between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). CONCLUSION: The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO(2), PCO(2), and HCO(3), but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.