Comparison Between Ventilator Hyperinflation and Manual Rib Cage Compression: Randomized Crossover Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 主要终点
- Static compliance of respiratory system
研究概览
简要总结
This is a randomized crossover trial to evaluate the effects of thoracic compression applied alone or in association with hyperinflation maneuver with the ventilator. In addition, the mobilized volume and peak expiratory flow resulting from both maneuvers will be evaluated.
详细描述
Ventilator hyperinflation is widely used in hypersecretive patients. It consists of increasing alveolar ventilation by facilitating the coughing mechanism so that the secretions of the peripheral airways are mobilized into the central airways so that they can be removed by tracheal aspiration or cough. Thoracic compression consists of manually compressing the rib cage during expiration, in order to increase expiratory flow, mobilize and remove pulmonary secretions. A randomized crossover clinical trial was performed with 30 patients submitted to isolated compression or associated with ventilator hyperinflation, with a 6 hour interval. Patients were evaluated through compliance and resistance of the respiratory system.
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
- None
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients under mechanical ventilation
- •diagnosis of pulmonary infection
- •hypersecretive
排除标准
- •haemodynamic instability (heart rate > 130 bpm and mean arterial pressure < 60 mmHg)
- •acute bronchospasm
- •acute respiratory distress syndrome
- •untreated pneumothorax
研究组 & 干预措施
Expiratory Rib Cage Compression
Expiratory rib cage compression was performed in 6 sets of 6 cycles, with 1 cycle interval. Ventilatory mode and parameters were maintained.
干预措施: Expiratory Rib Cage Compression (Other)
Compression + Ventilator Hyperinflation
Expiratory rib cage compression was performed in 6 sets of 6 cycles, with 1 cycle interval. Ventilator hyperinflation was performed by increasing the inspiratory pressure to every 5 cmH2O until the total pressure reached 40 cmH2O, remaining the same.
干预措施: Compression + Ventilator Hyperinflation (Other)
结局指标
主要结局
Static compliance of respiratory system
时间窗: Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration
Compliance was assessed through the occlusion maneuver at the end of inspiration, considering tidal volume, plateau pressure and PEEP. Three measurements were taken at each moment, the mean being used.
Total Resistance of respiratory system
时间窗: Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration
The total resistance of the respiratory system was evaluated through the occlusion maneuver at the end of the inspiration, considering the resistive pressure, measured by the difference between the maximum plateau pressure. Three measurements were taken at each moment, the mean being used.
Airway Resistance
时间窗: Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration
The airway resistance was assessed by means of the occlusion maneuver at the end of the inspiration, considering the rapid fall of the pressure immediately after the occlusion, measured by the difference between the maximum pressure and P1. Three measurements were taken at each moment, the mean being used.
Peak expiratory flow
时间窗: Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration
The peak expiratory flow was evaluated through passive expiration, being considered the greatest value of the flow in the expiratory phase.
次要结局
未报告次要终点
研究者
Luciano Matos Chicayban
Principal Investigator
Brazilian Institute of Higher Education of Censa