The Effect of Chest Physiotherapy Techniques Applied Before Aspiration on Vital Signs, Blood Gas Values and Secretion Amount in Patients on Mechanical Ventilation Support
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 78
- 试验地点
- 2
- 主要终点
- Effect of percussion vibration on blood gas parameters
研究概览
简要总结
Physiotherapy is one of the most frequently used supportive treatments in intensive care units due to its positive effects on critically ill patients. Chest physiotherapy (GF), which constitutes the most effective part of the physiotherapy programs applied to intensive care patients under mechanical ventilation (MV) support, consists of a series of techniques aimed at clearing airway secretions, facilitating appropriate lung ventilation by increasing lung volume and respiratory muscle strength, and improving the respiratory system and gas exchange. . Of these techniques, manually applied percussion vibration and expiratory rib cage compression (EGCC) are some of the most commonly applied GF techniques in patients on MV support. This study was conducted to evaluate the effect of chest physiotherapy techniques applied before aspiration on vital signs, blood gas values and amount of secretion in patients on mechanical ventilation support.
详细描述
This study was carried out to determine the effect of chest physiotherapy techniques applied before aspiration on the vital signs, blood gas values and amount of secretion in patients on mechanical ventilation support.This randomized, controlled and experimental study was conducted between May 2021 and October 2022 in Tunceli State Hospital intensive care units with patients on mechanical ventilation support. The study was completed with a total of 78 patients, including the percussion vibration group (n=26), the expiratory rib cage compression group (n=26), and the control group (n=26). Data were collected with the "Patient Identification Form", "Vital Signs Recording Form", "Blood Gas Values Recording Form" and "Secretion Amount Recording Form". Two aspirations were performed in each of the three groups with an interval of three hours. Three hours after the first aspiration, chest physiotherapy 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.In the comparison between groups according to time; Statistically significant changes were found in heart rate during the first aspiration period, and diastolic blood pressure and respiratory rate during the second aspiration period (p<0.05). In the independent comparison between groups; statistically significant difference was found in diastolic blood pressure, respiratory rate and peripheral SpO2 values (p<0.05). In group comparisons; while the averages of secretion weight and amount did not show a significant change in all three groups (p>0.05), it was found that it tended to increase in the percussion-vibration and expiratory rib cage compression groups, while it tended to decrease in the control group.In this study, it was concluded that chest physiotherapy techniques had a beneficial effect on some vital signs in patients on mechanical ventilation support, did not make any difference in other parameters. Further studies are needed to determine the positive effects of these techniques on vital signs, blood gases and secretion.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years and older
- •Intubated in the intensive care unit for more than 48 hours
- •Followed in synchronized intermittent mechanical ventilation (SIMV) mode
- •with arterial catheter
- •with hemodynamic stability
- •PEEP <10
- •Patients with Glasgow Coma Scale >3 were included.
排除标准
- •Rib fracture, chest trauma
- •with pneumothorax
- •with hemoptysis
- •with increased intracranial pressure
- •Having a history of spine surgery
- •with chest drainage tube
- •Those with skin infection and subcutaneous emphysema in the back and chest area
- •The mechanical ventilation setting to be changed during the study
- •with life-threatening cardiac arrhythmia
- •Obese (Body Mass Index >30)
- •Patients who had to be aspirated outside of the specified periods during the study were excluded from the study
研究组 & 干预措施
expiratory rib cage compression group
Expiratory rib cage compression procedure phase; Three hours after the first aspiration data were obtained, before the second aspiration, expiratory rib cage compression was applied for 5 minutes in the right lateral and left lateral positions, applying to both lungs, with the most affected lung area first. Before and after the procedure, vital signs, blood gas parameters were measured and the amount of secretion collected during the aspiration process was weighed.
干预措施: expiratory rib cage compression (Other)
percussion vibration group
Percussion, vibration process stage; Three hours after the first aspiration data were obtained, before the second aspiration, percussion and vibration were applied 3-5 times to each area, starting from the right and left lower lobes, in the right lateral and left lateral positions, with the most affected lung area being applied to both lungs first. Vital signs, blood gas parameters were measured before and after the procedure, and the amount of secretion collected during the aspiration process was weighed.
干预措施: percussion vibration (Other)
control group
Control group phase; In this group, vital signs, blood gases, and secretion amount were recorded at the same time as the experimental groups, without any intervention.
结局指标
主要结局
Effect of percussion vibration on blood gas parameters
时间窗: about a year
Percussion vibration was applied before endotracheal aspiration. Measurements of pO2, pH, pCO2, HCO3, SaO2 parameters were recorded 5 minutes before endotracheal aspiration and 25 minutes after applying percussion vibration
The effect of percussion vibration on the amount of secretion
时间窗: about a year
Pecussion vibration was applied before endotracheal aspiration, and the secretion accumulated in the collection container during the aspiration process was weighed and recorded.
Effect of expiratory rib cage compression on vital signs
时间窗: about a year
Expiratory rib cage compression was applied before endotracheal aspiration. Vital signs measurements such as systolic blood pressure, diastolic blood pressure, respiratory rate, pulse rate, body temperature, and peripheral SpO2 were recorded 5 minutes before endotracheal aspiration and 15 minutes after applying expiratory rib cage compression.
Effect of expiratory rib cage compression on blood gas parameters
时间窗: about a year
Expiratory rib cage compression was applied before endotracheal aspiration. Measurements of pO2, pH, pCO2, HCO3, SaO2 parameters were recorded 5 minutes before endotracheal aspiration and 25 minutes after applying expiratory rib cage compression.
Effect of expiratory rib cage compression on the amount of secretion
时间窗: about a year
Expiratory rib cage compression was applied before endotracheal aspiration, and the secretion accumulated in the collection container during the aspiration process was weighed and recorded.
Perküsyon vibrasyonun yaşam bulgularına etkisi
时间窗: about a year
Percussion vibration was applied before endotracheal aspiration. Vital signs measurements of systolic blood pressure, diastolic blood pressure, respiratory rate, pulse rate, body temperature, and peripheral SpO2 were recorded 5 minutes before endotracheal aspiration and 15 minutes after applying percussion vibration.
次要结局
未报告次要终点
研究者
Serap Parlar Kılıç
Proffessor
Inonu University