Acute Respiratory Distress Syndrome
Conditions
Interventions
Ccontrol group:Routine airway secretion management measures for mechanically ventilated patients include elevating the head of the bed by 30°–45°
repositioning the patient every 2 hours with chest percussion and limb mobilization, following the principles of percussing from the outer to the inner areas and from the lower to the upper regions to
performing oral care every 8 hours
using a heat and moisture exchanger to maintain the Y-piece temperature of the ventilator circuit between 34°C and 41°C and relative humidity at 100% to ensure adequate humidification of inspired gase
Intervention group:On the basis of the control group treatment, patients in the intervention group additionally received mechanical insufflation–exsufflation (MI-E) combined with closed suctioning thr
when oxygen saturation decreased and was suspected to be related to airway secretions
when, after excluding ventilator circuit vibration and condensate accumulation, the flow and/or pressure waveform on the ventilator display still showed a saw-tooth pattern
when a reduction in tidal volume during mechanical ventilation was suspected to be associated with increased airway secretions
or when peak inspiratory pressure increased during volume-controlled ventilation, suggesting the presence of upper airway secretions or regurgita
Sponsors
Hebei General Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Age >= 18 years old; 2. Meet the diagnostic criteria of the new global definition of ARDS in the 2023 edition; 3.The expected duration of mechanical ventilation >= 5 days; 4. Hemodynamic stability: 90 mmHg<= SBP<= 160 mmHg, 50 mmHg<= DBP<= 110 mmHg, and HR < 130 beats/min; 5. The patient or their legal representative consents to participate in this study.
Exclusion criteria
Exclusion criteria: 1. A history of or current presence of bullous emphysema, un drained pneumothorax or populations at high risk of pneumothorax, mediastinal emphysema, recent barotrauma, and tracheoesophageal fistula 2. Active intrapulmonary hemorrhage or hemoptysis; 3. Increased intracranial pressure; 4. Ruptured tympanic membrane.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sputum volume; | — |
Secondary
| Measure | Time frame |
|---|---|
| Arterial blood gas parameters;Vital signs;Duration of mechanical ventilation;Length of ICU stay;28-day mortality;Clinical Pulmonary Infection Score;The white blood cell;Procalcitonin;C-reactive protein; | — |
Countries
China
Contacts
Public ContactLiu Chunxia
Hebei General Hospital
Outcome results
None listed