Background: Accumulation of secretions in the airways of patients on mechanical ventilation (MV) can lead to serious complications. Chest physiotherapy (CP) techniques can be used prior to endotracheal aspiration to facilitate the removal of secretions accumulated in the respiratory tract.
Aim: This study was carried out to determine the effect of CP techniques applied before aspiration on the vital signs, blood gas values and amount of secretion in patients on MV support.
Study design: This randomised controlled trial was conducted in a State Hospital critical care unit with patients on MV support. The study was designed to include three groups: a percussion vibration (PV) group (n = 26) an expiratory rib compression (ERCC) group (n = 26) and a control group (n = 26). All three groups underwent two aspirations, three hours apart. Three hours after the first aspiration, CP techniques were applied to the two experimental groups, but not to the control group. A second aspiration was then performed. Vital signs and blood gases were measured before and after both aspiration procedures, and the amount of secretion collected during the two aspiration procedures was weighed.
Results: The study was completed with 78 patients. During the second aspiration, ERCC patients showed significant increases in diastolic blood pressure (DBP: 69.38 ± 10.58 → 73.23 ± 11.84 mmHg; p = 0.004; 95% CI: -3.250, 3.327) and heart rate (81.35 ± 10.43 → 85.73 ± 11.39 bpm; p = 0.004; 95% CI: -3.250, 3.327). Respiratory rate and body temperature also increased significantly (p = 0.006 and p = 0.034). SpO₂ increased in both PV (97.35 ± 1.67 → 97.81 ± 1.55%; p = 0.014) and ERCC (96.01 ± 2.66 → 96.67 ± 2.58%; p = 0.039) groups. No significant changes were observed in secretion weight or volume across groups, although PV and ERCC showed an increasing trend and the control group a decreasing trend (p > 0.05).
Conclusions: It was determined that CP techniques had an effect on DBP, heart rate, respiratory rate and SpO2 in patients under MV support, but had no effect on other parameters.
Relevance to clinical practice: The use of CP techniques by critical care nurses before aspiration may facilitate the removal of secretions in patients receiving MV support, prevent complications related to secretions and positively improve vital signs and hemodynamic indices.
Trial registration: ClinicalTrials.gov. No: NCT06277817.
Keywords: chest physiotherapy; expiratory rib cage compression; intensive care; mechanical ventilation; percussion‐vibration.
© 2026 British Association of Critical Care Nurses.