Mechanical Ventilation Complication
Conditions
Keywords
chest drain
Brief summary
This study evaluates the comparison of two of re-expansion pulmonary physiotherapy in patients with chest tube. The study group received intermittent positive pressure intervention and the control group received incentive spirometry intervention associated with manual operation.
Detailed description
All the re-expansion methods increase lung volume increasing gradient of transpulmonary pressure (PL) representing the difference alveolar pressure and pleural pressure. Spontaneous deep breath increases the PL by reducing pleural pressure (active breathing exercises, breathing supporters and manual operation). Muller resuscitator consists of a pneumatic valve feature designed to operate with medical oxygen. It is used intermittently or continuously for pulmonary re-expansion, with lower load imposed work, and increase the efficiency of gas exchange by improving volumes, lung capacity and breathing pattern, and reverse atelectasis. However, studies show the paucity of data in the literature regarding the Muller Resuscitator in different forms and respiratory rehabilitation protocols. In addition, studies show lack of standardization of methods and resources used in respiratory therapy in patients with chest tube.
Interventions
DEVICEReanimator group
Resuscitator of Muller Group (intermittent positive pressure): Patients allocated to this group received intermittent positive pressure breathing (resuscitator Muller, Engemed, Brazil), adjusting the positive pressure around 1.5 kgf / cm2, which corresponds to 15 20 cm / H2O, positive pressure was applied through a face mask (Respironics®).
DEVICEControl
Control Group: In position Fowler 45, patients assigned to this group was administered as treatment lung expansion exercises using the incentive inspiratory flow (Respiron, NCS, Mexico) and concomitantly blocking contralateral to the drain maneuvers were performed, compression / decompression associated with the incentive spirometry (Respiron) consisting of 4 sets of 10 active patient breaths with an interval of two minutes between sets. Since the load of the respiratory stimulator will be zero throughout treatment. Guidelines to the active, progressive and early mobilization.
Sponsors
University of Campinas, Brazil
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients with old more 18 years untill 65 years * Patients undergoing thoracic drainage * That does not include in any
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change Respiratory function | before the intervention (pre) and after drain removal the tube (pos) for 30 days | Ventilometry was evaluated in two stages: 1) before the intervention, 2) on the day of drain removal or discharge. The spirometer application is according to implement stable and acceptable criteria. TOBIN The measures of lung volumes forão performed with the spirometer (FERRARIS MK8 Wright ®) coupled to a nozzle. The patient was instructed to breathe quietly in the apparatus for a minute to read the minute volume (VM). During this period, it is checked the number of breaths, i.e., respiratory rate (RR) for calculating the tidal volume (VT) given by VC = VM / FR (ml). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Saturation Oxygen | 30 days | Oxygen saturation was assessed in two stages: 1) before the first intervention of the day 2) after daily intervention protocol until hospital discharge or removal of the chest tube. Patients were evaluated with breathing in ambient air (without supplemental oxygen) after 10 minutes of the procedure. The researcher used a pulse oximeter portable. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Pain | 30 days | by visual analogue scale of pain (VAS) was used to determine the degree of soreness daily during the hospitalization period and pre chest drainage and after the intervention. |
| Hospitalization stay | 30 days | the number of days in the hospital after chest drainage to discharge should be recorded for each patient. All patients were followed during hospitalization. |
| Time length chest drain | 30 days | The length of the chest drain was checked until hospital discharge. The drain removal criterion was filed by the medical team of the hospital thoracic surgery. Debt drain in ml was collected by nursing professionals who were blinded study. |
| dyspnea | 30 days | It was determined by the Borg scale, in two stages, before and after intervention in both groups. |
Countries
Brazil
Contacts
Primary ContactAna Paula R Dos Anjos, mestranda
Backup ContactLuiz C Martins, Doutor
Outcome results
None listed