. 2013 Oct-Dec;25(4):327–333. doi: 10.5935/0103-507X.20130055

Table 3.

Characteristics of selected clinical trials published between 2002 and 2012 analyzing the effects of respiratory physiotherapy on the intracranial pressure of critically ill patients

Author	Sample (N)	Sample characteristics	Intervention	Intervention time	Key variables	Significant outcomes
Thiesen et al.⁽¹⁹⁾	35	Severe TBI, undergoing IMV, GCS ≤8, mean age of 24.9 years	Manual expiratory pressure with manual rib vibration; manual expiratory pressure with manual diaphragmatic vibration, postural drainage + tapping; expiratory manual pressure with rib decompression, manual expiratory pressure with diaphragmatic decompression, ETA (30 minutes)	1 single session	ICP, MAP, CPP	Increase in ICP during manual epressure maneuvers with manual dvibration, postural drainage with tapETA
Nemer et al.⁽²⁰⁾	70	53 severe TBI and 17 strokes undergoing IMV; GCS ≤8, mean age 45.9±20.2 years	Chest compression, vibration in combination with chest compression; unilateral continuous chest compression; open circuit and closed circuit ETA (16 minutes)	1 single session	ICP	Three procedures significantly chanICP: unilateral continuous chest comopen circuit and closed circuit ETA
Toledo et al.⁽²¹⁾	11	Severe TBI, undergoing IMV, age ≥18 years, less than 24 hours in the ICU	Bilateral manual vibrocompression maneuvers; ETA (20 minutes)	2 times a day for 3 days	ICP, MAP, CPP	Increase in ICP after the ETA maneuve
Olson et al.⁽²²⁾	28	Neurological or neurosurgical diagnosis, age ≥18 years	IG (n=13) - manual mechanical percussion maneuvers (10 minutes)	1 single session	ICP, BP, HR, RR, SpO₂	There were no statistically sdifferences between the ICP of compared to the CG
Olson et al.⁽²²⁾	28	Neurological or neurosurgical diagnosis, age ≥18 years	CG (n = 15) - no intervention	1 single session	ICP, BP, HR, RR, SpO₂
Cerqueira-Neto et al.⁽²³⁾	20	Severe TBI, undergoing IMV, GCS ≤8, mean age 33.5±11.94 years	Unilateral manual vibrocompression maneuvers and increased expiratory flow (5 minutes) in each hemithorax; ETA (10-15 seconds)	1 single session	ICP, MAP, CPP	Increased ICP and MAP, with consduring the ETA maneuvers

TBI - traumatic brain injury; IMV - invasive mechanical ventilation, GCS - Glasgow coma scale; ETA - endotracheal aspiration; ICP - intracranial pressure, MAP - mean arterial pressure; CPP - cerebral perfusion pressure; ICU - intensive care unit, IG - intervention group, CG - control group, BP - blood pressure, HR - heart rate, RR - respiratory rate, SpO₂ - oxygen saturation.