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The effect of expiratory rib – cage compression before endotracheal suctioning on arterial blood oxygenationThe effect of expiratory rib – cage compression before endotracheal suctioning on arterial blood oxygenationmechanically ventilated patients

Not Applicable
Conditions
patients under mechanical ventilation.
J00-J99
Registration Number
IRCT201205079664N1
Lead Sponsor
Zanjan University of Medical Sciences and Health Services
Brief Summary

In patients undergoing mechanical ventilation, mucus production and secretion is high as a result of the endotracheal tube. Because endotracheal suction in these patients is essential, chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretion and improving alveolar ventilation. As one of the complications of mechanical ventilation and endotracheal suctioning is decrease of cardiac output, this study was carried out to determine the effect of expiratory rib cage compression before endotracheal suctioning on the vital signs in patients under mechanical ventilation. This study was a randomized clinical trial with a crossover design. The study subjects included 50 mechanically ventilated patients, hospitalized in intensive care wards of Valiasr and Mousavi hospitals in Zanjan, Iran. Subjects were selected by consecutive sampling and randomly allocated to groups 1 and 2. The patients received endotracheal suctioning with or without rib cage compression, with a minimum of 3 h interval between the two interventions. Expiratory rib cage compression was performed for 5 min before endotracheal suctioning. Vital signs were measured 5 min before and 15 and 25 min after endotracheal suctioning. Data were recorded on a data recording sheet. Data were analyzed using paired t-tests. There were statistically significant differences in the means of vital signs measured 5 min before with 15 and 25 min after endotracheal suctioning with rib cage compression (P < 0. 01). There was no significant difference in the means of diastolic pressure measured 25 min after with baseline in this stage). But on the reverse mode, there was a significant difference between the means of pulse and respiratory rate 15 min after endotracheal suctioning and the baseline values (P < 0.002). This effect continued up to 25 min after endotracheal suctioning just for respiratory rate (P = 0.016). Moreover, there were statistically significant differences in the means of vital signs measured 5 min before and 15 min after endotracheal suctioning between the two methods (P = 0001). Findings showed that expiratory rib cage compression before endotracheal suctioning improves the vital signs to normal range in patients under mechanical ventilation. More studies are suggested on performing expiratory rib cage compression before endotracheal suctioning in patients undergoing mechanical ventilation.

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete
Sex
Male
Target Recruitment
50
Inclusion Criteria

men patients with stable hemodynamic status within 18-70 years old, wiht Hct more than 25%, without hyperthermia, chest injury, chst tube, chest surgery and ventilated on PEEP mode, patient with active asthma and emphysema, using endotracheal suctioning 1 hours before intervention.
Exclusion criteria: reciving any kind of parlytic mascular drug like Pavlon in invention time zone, start/stop or chnage in vasodilator drug in invention time zone, change in ventilator setup, using endotracheal suctioning 1 hours before each phase of intervention, changing ventilator mode as with CMV mode.

Exclusion Criteria

Not provided

Study & Design

Study Type
interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Arterial blood oxygenation. Timepoint: 5 minutes befor and 15 and 25 minutes after intervention in each phase. Method of measurement: using vital sign monitoring system with Poyandegan Rahe Saadat made in Iran.
Secondary Outcome Measures
NameTimeMethod
Vital sign including Blood pressure, pulse, respiratory rate. Timepoint: 5 minutes before and 15 and 25 after intervention in each phase. Method of measurement: mm/hg for BP, number for Pulse and respiratory rate announced by vital sign monitoring system Pooyandegan rahe Saadat made by Iran.
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