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First published on March 19, 2009, doi:10.4037/ajcc2009523

American Journal of Critical Care 2009;18:330.

Copyright © 2009 by the American Association of Critical-Care Nurses.
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RESEARCH-ARTICLE

Effect of Mechanical Chest Percussion on Intracranial Pressure: A Pilot Study

By DaiWai M. Olson, RN, PhD, CCRN, Suzanne M. Thoyre, RN, PhD, Stacey N. Bennett, RN, MSN, ACNP, Joanna B. Stoner, RN and Carmelo Graffagnino, MD, FRCP. From DaiWai M. Olson is a clinical research associate, Stacey N. Bennett is an acute care nurse practitioner, Joanna B. Stoner is a research coordinator, and Carmelo Graffagnino is an associate professor at Duke University Medical Center, Durham, North Carolina. Suzanne M. Thoyre is an associate professor at the University of North Carolina at Chapel Hill

Corresponding author: DaiWai Olson, Box 2900, Bryan Research Bldg, Duke University, Durham, NC 27710 (e-mail:Olson006{at}mc.duke.edu).

Abstract

Background: Treatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdotal evidence indicates that physical stimulation increases intracranial pressure and should be avoided in patients at risk of intracranial hypertension.

Objectives: To explore the safety of performing chest percussion for patients at high risk for intracranial hypertension.

Methods: A total of 28 patients with at least 1 documented episode of intracranial hypertension who were having intracranial pressure monitored were studied in a prospective randomized control trial. Patients were randomly assigned to either the control group (no chest percussion) or the intervention group (10 minutes of chest percussion at noon). Intracranial pressure was recorded once a minute before, during, and after the intervention.

Results: Mean intracranial pressures for the control group before, during, and after the study period (14.4, 15.0, and 15.9 mm Hg, respectively) did not differ significantly from pressures in the intervention group (13.6, 13.7, and 14.2 mm Hg, respectively).

Conclusions: Mechanical chest percussion may be a safe intervention for nurses to use on neurologically injured patients who are at risk for intracranial hypertension.




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Nursing Care and Intracranial Pressure Monitoring
Am. J. Crit. Care., July 1, 2009; 18(4): 338 - 338.
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Copyright © 2009 by the American Association of Critical-Care Nurses.