Chest physical therapy. The immediate effect on oxygenation in acutely ill patients.

There is no documentation in the literature of the risk of hypoxemia after chest percussion in acutely ill adults with nonsurgical pulmonary disorders. We studied the immediate effect of postural drainage and chest percussion (PDP) on oxygenation in 22 hospitalized patients with a variety of acute, nonsurgical pulmonary disorders. Heart rate, respiratory rate, blood pressure, and arterial blood gas levels were measured at four points before, during, and after PDF. There was a significant fall in PaO 2 after chest percussion in ten patients who produced no sputum or small amounts of mucoid sputum. The mean PaO 2 fell 16.8 mm Hg ( P P 2 in 12 patients who produced moderate to large amounts of mucopurulent secretions. The fall in PaO 2 was probably due to increased ventilation-perfusion mismatch since this fall was avoided in two patients restudied while receiving 100 percent oxygen. We conclude that all acutely ill patients receiving PDP should be carefully monitored and, if necessary, should receive increased levels of inspired oxygen to avoid hypoxemia. Our data suggest that the use of PDP in patients without sputum production is not indicated and is potentially dangerous.