Impact of Ipsilateral Decubitus Forced Expiration On Duration of Pleural Drainage After Pulmonary Surgery in Children : Randomized Trial
试验速览
- 阶段
- 不适用
- 入组人数
- 140
- 试验地点
- 19
- 主要终点
- assessment of pleural drainage duration
研究概览
简要总结
Following thoracic surgery, pleural effusion in pleural cavity requires post-operative drainage.
Pleural effusion is responsible for pulmonary congestion, atelectasis, hypoventilation, lower efficacy of diaphragmatic curse, lower pulmonary reexpansion and vicious attitude. These complications could be avoided by respiratory physiotherapy.
Forced expiration technic in ipsilateral decubitus is one of these technics but has never been proved better than other technics regarding its efficiency.
The aim of the study is to compare the impact of such a technic on post operative thoracic drainage after pulmonary, pleural or mediastinal pediatric surgery.
详细描述
Following thoracic surgery, pleural effusion in pleural cavity requires post-operative drainage, most often for few days (2 to 5 days) until fluid quantity is lower than 50 mL / 24h.
Pleural effusion may cause pulmonary congestion, atelectasis, hypoventilation, lower efficacy of diaphragmatic curse, lower pulmonary reexpansion and vicious attitude.
Respiratory physiotherapy in such situations has different aims : pulmonary decongestion and reexpansion, aid for drainage and pleural fluid reduction, avoiding complications and preventing vicious attitudes.
These aims are learned in Physiotherapy formation institutes. The forced expiration technic in ipsilateral decubitus is justified by pleural physiology and is used after pediatric surgery without any scientific evidence regarding his efficacy Using pulmonary physiotherapy after pulmonary, mediastinal or pleural surgery for children is not systematic and depends on prescriber without any professional recommendation.
Actually no scientific evidence regarding technical or postural indicates improvement of effusion drainage.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 1 Day 至 48 Weeks（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Children 0-4 years
- •In front have a mediastinum or lung surgery (lung segmentectomy or lobectomy or non anatomical lung resection) with pleural drainage, regardless of the type drain
- •Whose parents or the holder of parental authority have signed a consent
- •Whose parents or the holder of parental authority are affiliated to a social security scheme
排除标准
- •chest trauma
- •Oncology (chest tumors, lung metastases)
- •Drained Pleuropneumopathies
- •Spine Surgery
- •Heart surgery
- •Surgery for pectus excavatum
- •Route of anterior surgical approach sternotomy chest kind
- •Patients intubated and / or ventilated
- •Patients with preoperative sepsis
研究组 & 干预措施
forced expiration
2 daily sessions of forced expiration on ipsilateral decubitus from day 1 after surgery until chest tube removal
干预措施: Forced expiration (Procedure)
control
No session of forced expiration
结局指标
主要结局
assessment of pleural drainage duration
时间窗: 3 days
During the post-operative period until chest tube removal amount of pleural liquid drained is daily assessed.
次要结局
- assessment of total amount of pleural liquid drained(3 days)
- Assessment of pain(3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 5, 48)
- patient's respiratory parameters(3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48)
- paramedical workload(3 days)
- Oxygen blood saturation(3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48)