Immediate Effect of Expiratory Positive Airway Pressure and Breath Stacking in Non-cooperative Patients Detected by Electrical Impedance Tomography
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- Regional Lung Aeration
研究概览
简要总结
The survival of patients with lesions in the central nervous system is usually accompanied by physical and mental sequelae. These impairments favor the prolonged restriction to the bed, which may contribute with changes in respiratory function. In this context, lung re-expansion techniques are used to prevent or treat the various respiratory complications.
详细描述
The survival of patients with lesions in the Central Nervous System is usually accompanied by physical and mental permanents sequelae. This impairment of cognitive status associated with motor injury favors prolonged restriction of these patients to the bed, which may contribute to the emergence of other health damages. In the clinical practice, lung expansion techniques has been used as a prophylaxis and treatment of respiratory conditions that involve volumetric reductions. However, the deficit of awareness and cooperation difficult the use of several therapeutic resources. There are few interventions that could be proposed due to no need the collaboration to be performed, such as Breath Stacking technique (BS) and Expiratory Positive Airway Pressure (EPAP). The BS is characterized by execution of inspiratory cycles through a one way valve, which allows stacked volume of gas during each inspiration, until it reaches values approximate to maximum inspiratory capacity. While in the EPAP, alveolar pressure is elevated to breath against a expiratory flow resistance generated by a spring load valve. The effects on lung volume promoted BS and EPAP can be safely measured using an electrical impedance tomography (EIT). This recent imaging modality offers information about lung air volumes distribution and have a strong linear correlation with regional ventilation within the thorax. The effects on lung volume promoted BS and EPAP can be safely measured using an EIT monitor. This recent imaging modality offers information about lung air volumes distribution and have a strong linear correlation with regional ventilation within the thorax. Until this moment, there is not description about the effect of lung expansion techniques on regional lung parameters.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patients undergoing neurosurgery restricted to bed for more than 14 days;
- •Aged between 18 and 65 years;
- •Glasgow Coma Scale < 10 points;
- •Breathing spontaneously through the tracheostomy tube;
- •No respiratory infection;
- •Chest circumference between 88 and 98 centimeters;
排除标准
- •Presence of chronic lung diseases;
- •Chest deformity;
- •Rib fracture;
- •Asymmetrical chest expansion;
- •Abdomen distension;
- •Spasticity in any hemisphere with Ashworth Scale score more than 2 points for upper limbs;
- •Uncoordinated movements of the limbs;
- •Cardiorespiratory instability (heart rate < 60 or > 120 bpm; respiratory rate > 35 ipm; mean arterial pressure < 60 mmHg or > 120 mmHg; oxygen saturation < 90%).
研究组 & 干预措施
EPAP Group
The EPAP devices increase the alveolar pressure. This effect is obtained through valves that generate a resistance to airflow during expiration.
干预措施: EPAP (Other)
Breath Stacking Group
The Breath Stacking consists on the implementation of subsequent inspiratory efforts through a one way valve, which allows stacked volume of gas during each inspiration, until it reaches a maximum lung volume.
干预措施: Breath Stacking (Other)
结局指标
主要结局
Regional Lung Aeration
时间窗: Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.
Change in Regional Lung Aeration (difference between the End-Expiratory Lung Impedance before and post-intervention). Each image along the time represent the relative change in impedance distribution within the transverse section of the chest, from the first scan (before intervention) to current scan. The pixel values are express as percentage changes of local impedance.
次要结局
- Mean Arterial Pressure(Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.)
- Respiratory Rate(Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.)
- Heart Rate(Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.)
- Periferic Saturation of Oxygen(Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.)
- Regional Lung Ventilation(Before and 1, 5, 10, 15, 30, 60, 90, 120 minutes post-intervention.)
研究者
Caio César Araújo Morais
Specialist in cardiopulmonary physiotherapy
Universidade Federal de Pernambuco
