Effect of Combined Manual Hyperinflation and Standard Physical Therapy Program on Lung Recruitment in Mechanically Ventilated Pediatric Patients: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 32
- 试验地点
- 2
- 主要终点
- change the respiratory functions
研究概览
简要总结
The purpose of this study is to investigate the immediate combined effects of Manual Hyperinflation and standard Physical therapy program on lung recruitment and secretion mass in mechanically ventilated pediatric patients aged between 10-15 years 'old
详细描述
In developing countries, lower respiratory tract infection is a major cause of death in children, with severely ill patients being admitted to the critical-care unit. While physical therapists commonly use the manual hyperinflation (MHI) technique for secretion mass clearance in critical-care patients, its efficacy has not been determined in pediatric patients.
Manual hyperinflation is a frequently maneuver used in critically ill intubated and mechanically ventilated patients. With MHI, patients are disconnected from the mechanical ventilator after which their lungs are temporarily ventilated with a manual ventilation bag. so, by applying a larger than normal volume at a low inspiratory pause and expiration with a high expiratory flow, MHI is suggested to mimic a normal cough.
Propagation of airway secretions from the smaller toward the larger airways, then allows for easy removed of airway secretions with the airway suction. finally, MHI could prevent airway plugging and even promote alveolar recruitment. so the aim of the study is to enhance lung recruitment using MHI combined with standard Physical therapy program
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)
盲法说明
using sealed envelopes,
入排标准
- 年龄范围
- 10 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The patients will be aged 10-15 years,
- •receiving mechanical ventilation via an endotracheal tube for at least 24 h
- •presenting with vital signs in the normal range.
- •All patients are suffering from lower respiratory tract infection like pneumonia, bronchitis and acute exacerbation of bronchiectasis
排除标准
- •Patients with history of thoracic surgery
- •Patients with pneumothorax or acute respiratory distress syndrome
- •Patients with severe acute head injury
- •Patients use inotropes and vasopressors drugs
- •Patients with severe Broncho pleural fistula, rib fracture, emphysema bullae, lung abscess, patients with history of preterm birth or heart disease.
- •Patients who requiring mechanical ventilation with a peak inspiratory pressure (PIP)
结局指标
主要结局
change the respiratory functions
时间窗: 2 weeks
By increasing tidal volume
change the respiratory mechanics
时间窗: 2 weeks
increasing inspiratory capacity
change the bronchospasm
时间窗: 2 weeks
modifying mean airway pressure
change the amount of ventilation
时间窗: 2 weeks
increasing the oxygen saturation
次要结局
- decreasing the amount of secretions(2 weeks)
- weaning from mechanical ventilator(from 2 to 4 weeks)
研究者
Mohamed Abdel Moeim Abo EL Ros
Lecturer of Physical Therapy for Pediatrics and its Surgeries
New Ismailia National University