Physiological Effects of the Application of Secretion Removal Device in Invasively Ventilated Patients
试验速览
- 阶段
- 不适用
- 入组人数
- 20
- 主要终点
- Changes in passive respiratory mechanics
研究概览
简要总结
In this study the investigators will assess the effects of secretion removal on "noninvasive" respiratory mechanics, in deeply sedated mechanically ventilated patients All the mechanically ventilated patients will be submitted to the recording of compliance and resistance at baseline (time0), immediately after the application of 10 cycles alternating 30 cmH20 during expiration and -30 cmH20 during exhalation (time1). Afterward the patients will undergo an additional trail using the so called "percussion" technique, to assess any synergic effect of this procedure (time2)
详细描述
In this observational study, the investigators will assess the effects of two secretion removal techniques on passive respiratory mechanics, in patients undergoing invasive mechanical ventilation.
Consecutive patients will undergo 3 sequential assessments at time0 (baseline), at time1 after the application of of 10 cycles alternating 30 cmH20 during expiration and -30 cmH20 during exhalation and finally after a 20 sec application of a "percussion technique".
Protocol:
The patients will be ventilated without PEEP and sedated with a benzodiazepine infusion to produce complete relaxation and adaptation to the ventilator, as assessed by the complete absence of spontaneous efforts, so that there was no change in inspiratory flow rate, tidal volume, or respiratory rate during the three measurement periods.
Airway pressure (Paw) and flow (V) will be measured continuously throughout the respiratory cycle with the transducer and expiratory tidal volume will obtained by electrical integration of the flow signal.
研究设计
- 研究类型
- Interventional
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
盲法说明
patients deeply sedated and therefore not conscious
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •consecutive ventilated and intubated patients
- •age> 18 yrs
- •Sign inform consent
- •clinical indication for secretion removal from the endotracheal tube
排除标准
- •tracheotomy
- •bullous emphysema
- •pneumothorax
研究组 & 干预措施
in-exufflator and percussion technique
assess the physiological effects, of a "common" daily practice of secretion removal in intubated patients, that are: in-exufflator technique and percussion technique
干预措施: in-exufflator technique (Device)
in-exufflator and percussion technique
assess the physiological effects, of a "common" daily practice of secretion removal in intubated patients, that are: in-exufflator technique and percussion technique
干预措施: percussion technique (Device)
结局指标
主要结局
Changes in passive respiratory mechanics
时间窗: immediate
RESPIRATORY MECHANICS is monitored using the end-expiratory and end inspiratory technique, obtained pressing the hold command on the ventilator
次要结局
- changes in arterial blood gases(immediate)
研究者
dr. Stefano Nava
Chief of Respiratory and Critical Care unit
IRCCS Azienda Ospedaliero-Universitaria di Bologna