stroke
Conditions
Interventions
Control group:Mechanical Insufflation-Exsufflation
Experimental group:Mechanical Insufflation-Exsufflation
Sponsors
Zhejiang Provincial People's Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Definitive diagnosis of stroke (including ischemic stroke, cerebral hemorrhage or subarachnoid hemorrhage, etc.), and stroke-related neurological dysfunction as the main underlying disease; 2.Tracheostomy artificial airway has been established, and currently receiving invasive mechanical ventilation support (including control/assisted control, SIMV, PSV, CPAP/PS, etc., spontaneous breathing can exist, but still ventilator-assisted ventilation), and is expected to be managed by a ventilator and undergo airway clearance treatment in the next 5 days; 3.Unable to actively cooperate with sputum training, pulmonary rehabilitation, or directive breathing maneuvers due to impaired consciousness, severe aphasia, cognitive impairment, or obvious neurological deficits; 4.Presence of secretion retention (eg, viscous sputum, frequent sputum suction, weak cough, or pronounced sputum sounds); 5.Lung ultrasound before the first study intervention showed a certain degree of decrease in lung air content, and the 12-zone lung ultrasound score (LUS) was used, with a total LUS score of >= 6 points and at least one lung area score of >=2 points; 6.Vital signs are relatively stable and tolerable to MIE, MHI point-of-care therapy; 7. Age >= 18.
Exclusion criteria
Exclusion criteria: 1.Combined with severe chronic obstructive pulmonary disease, or at clear risk of severe expiratory airflow restriction or dynamic hyperinflation; 2.Combined with acute severe asthma, active bronchospasm, or recent significant airway hyperresponsiveness; 3.Those who are not suitable for MIE or MHI due to pulmonary bullae, undrained pneumothorax, recent barotrauma, etc; 4.Active hemoptysis, recent severe airway or chest injury; 5.Severe hemodynamic instability (requiring continuous high-dose vasopressors or presence of refractory arrhythmias); 6.Significantly increased intracranial pressure, high risk of cerebral herniation, or clinical judgment that the intervention of this study is not appropriate;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Lung ultrasound score (LUS); | — |
Secondary
| Measure | Time frame |
|---|---|
| Wet weight of sputum;Occurrence of adverse events;Respiratory compliance;Oxygenation index and sputum suction frequency;Mechanical ventilation related outcomes; | — |
Countries
China
Contacts
Public ContactJunyi Xiang
Zhejiang Provincial People's Hospital
Outcome results
None listed