Effect of Lung Volume Recruitment Technique After Extubation

Inclusion Criteria: * Forty to sixty years old patients had undergone mechanical ventilation for ≥ 48 hours in a controlled mode and had been weaned after a successful spontaneous breathing trial with suboptimal or poor CPF \< 270 L/min. * Patients were able to assume a sitting position. * All participants were aware, cooperative, competent, able to comply with treatment, and able to understand and follow instructions. Exclusion Criteria: * Presence of significant or active hemoptysis, untreated or recent pneumothorax, bullous emphysema, lung trauma, or recent lobectomy. * Patients with comorbidities interfering and compromising the success of either weaning or extubation, like cardiac arrhythmia, pericardial effusion, congestive heart failure, or acute coronary syndrome. * Patients who had originally inadequate training performance of the respiratory muscle such as those having NMD, i.e., myopathy or neuropathy. * Impaired consciousness/inability to communicate. * Patients who had a neurological deficit resulted in bulbar affection. * Patients with indications for MV, but contraindicated for physical therapy like pulmonary embolism. * Patients who had undergone tracheotomy before extubation also were excluded or who had experienced less than 24 hours of mechanical ventilation. * Patients with unstable hemodynamics or cardiac instability. * Current undrained pleural effusion or previous pneumothorax or barotrauma. * Uncontrolled severe COPD, poorly controlled asthma, and s…