Bag Squeezing and Manual Hyperinflation: Different Techniques or Merely Synonyms? - Abstract
Objective: To describe procedures, indications and contraindications for bag squeezing and manual hyperinflation maneuvers and to propose an algorithm to optimize use of these techniques.
Methods: A narrative literature review based on searches in the SciELO, ScienceDirect, PubMed and PEDro databases as well as the SECAD online continuing education system. The following descriptors were used: physical therapy modalities, inflation, airway obstruction, respiratory therapy and critical care.
Bag squeezing: A physical therapy maneuver primarily for airway clearance and lung re-expansion. The maneuver is used with manual hyperinflation and compression of the chest followed by tracheal suctioning.
Manual hyperinflation: A physical therapy maneuver that can technically be performed by physicians and nurses to ensure bronchial hygiene. The maneuver is characterized by the use of a self-inflating bag and slow manual compression, with a plateau being maintained for 2 to 3 seconds before abrupt decompression.
Conclusion: Both bag squeezing (BS), and manual hyperinflation (MH), help with mechanical ventilation, oxygenation and airway clearance and re-expansion. However, BS is more effective than MH due to manual compression of the chest.