Effects of Ventilator Hyperinflation Versus Vibrocompression in Mechanically Ventilated Patients

Inclusion Criteria: * Eighty-one mechanically ventilated patients more than 48 hours up to 7 days * Their ages range from 35 to 55 years old. * Medical stability (mean arterial pressure \> 60 \< 110, systolic blood pressure \> 80, diastolic blood pressure \> 60, fraction of inspired oxygen \< 60, positive end expiratory pressure (PEEP) \<10) Exclusion Criteria: Patients will be excluded if they have the following conditions or diseases: * Unstable hemodynamics * Fraction of inspired oxygen (FiO2) ≥ 0.6 * PEEP ≥ 10 cmH2O * undrained pneumothorax and hemothorax or subcutaneous emphysema * Pulmonary pathology (e.g., acute respiratory distress syndrome, exacerbation of chronic obstructive pulmonary disease, and acute pulmonary edema) * Unstable neurological problems (raised intracranial pressure). * Lung Cancer * Recent/unhealed rib fracture * Any disease obstructs our study.