Pulmonary Infection
Conditions
Keywords
mechanical ventilation, chest physiotherapy, critical care, pneumonia, Mechanically ventilated patients with pulmonary infection.
Brief summary
This is a randomized crossover study, designed to evaluate if the manual expiratory rib cage compression technique improves respiratory mechanics and is effective in secretion removal in mechanically ventilated patients.
Detailed description
Chest physiotherapy is an essential component of the multidisciplinary approach in critical care settings. In this context, a number of devices and manual techniques have been used to remove pulmonary secretions and re-expand collapsed areas. This study was designed to evaluate whether manual rib cage compression improves airway clearance and respiratory mechanics in mechanically ventilated patients. In a randomized crossover trial, 20 mechanically ventilated patients underwent thoracic manual compression and control intervention (normal ventilation) at the same day. The main outcomes were sputum production and the changes in respiratory mechanics.
Interventions
The therapist hands were positioned on the lower ribs, and the force was applied every two breaths only during the expiration, synchronizing the maneuver rate with the patient's respiratory rate. Then, the patients underwent a suctioning procedure, and a hyperinflation maneuver consisting of a 10 minutes period under pressure support ventilation of 35 cmH2O was done. In control intervention instead of the compressive maneuver the patients were kept on normal ventilation.
Sponsors
Centro Universitário Augusto Motta
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
19 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* patients under mechanical ventilation * diagnosis of pulmonary infection * hypersecretive (defined as the interval between tracheal suctioning \< 2 hours)
Exclusion criteria
* haemodynamic instability (defined by heart rate \> 130 bpm and mean arterial pressure \< 60 mmHg) * use of vasopressor drugs * absence of respiratory drive * acute bronchospasm * acute respiratory distress syndrome * atelectasis (identified by an independent radiologist that was not participating in the study) * untreated pneumothorax * lung haemorrhage.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sputum Volume (mL) | Day 1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory Mechanics | Day 1 | Static and effective compliance of the respiratory system Total resistance of the respiratory system |
Countries
Brazil
Outcome results
None listed