Mechanical Ventilation Complication, Physical Disability
Conditions
Keywords
MHI, Physical Therapy, Mechanically ventilated patients
Brief summary
The purpose of this study is to investigate the immediate combined effects of Manual Hyperinflation and standard Physical therapy program on lung recruitment and secretion mass in mechanically ventilated pediatric patients aged between 10-15 years 'old
Detailed description
In developing countries, lower respiratory tract infection is a major cause of death in children, with severely ill patients being admitted to the critical-care unit. While physical therapists commonly use the manual hyperinflation (MHI) technique for secretion mass clearance in critical-care patients, its efficacy has not been determined in pediatric patients. Manual hyperinflation is a frequently maneuver used in critically ill intubated and mechanically ventilated patients. With MHI, patients are disconnected from the mechanical ventilator after which their lungs are temporarily ventilated with a manual ventilation bag. so, by applying a larger than normal volume at a low inspiratory pause and expiration with a high expiratory flow, MHI is suggested to mimic a normal cough. Propagation of airway secretions from the smaller toward the larger airways, then allows for easy removed of airway secretions with the airway suction. finally, MHI could prevent airway plugging and even promote alveolar recruitment. so the aim of the study is to enhance lung recruitment using MHI combined with standard Physical therapy program
Interventions
DEVICErehabilitation of mechanically ventilated patients
1. mechanical ventilation 2. silicon resuscitation bag (500ml) connected to pressure manometer with an oxygen flow of 10 l.min-1 3. Endotracheal closed suction with pressure control ventilation (PCV)
PROCEDUREsupportive care
\- Children in study group B will receive standard Physical therapy program including suction, percussion and vibration with total duration of session in group a will be 15 minutes, daily for successive two weeks
Sponsors
New Ismailia National University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Masking description
using sealed envelopes,
Intervention model description
randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
10 Years to 15 Years
Healthy volunteers
No
Inclusion criteria
* The patients will be aged 10-15 years, * receiving mechanical ventilation via an endotracheal tube for at least 24 h * presenting with vital signs in the normal range. * All patients are suffering from lower respiratory tract infection like pneumonia, bronchitis and acute exacerbation of bronchiectasis
Exclusion criteria
* Patients with history of thoracic surgery * Patients with pneumothorax or acute respiratory distress syndrome * Patients with severe acute head injury * Patients use inotropes and vasopressors drugs * Patients with severe Broncho pleural fistula, rib fracture, emphysema bullae, lung abscess, patients with history of preterm birth or heart disease. * Patients who requiring mechanical ventilation with a peak inspiratory pressure (PIP)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change the respiratory functions | 2 weeks | By increasing tidal volume |
| change the respiratory mechanics | 2 weeks | increasing inspiratory capacity |
| change the bronchospasm | 2 weeks | modifying mean airway pressure |
| change the amount of ventilation | 2 weeks | increasing the oxygen saturation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| decreasing the amount of secretions | 2 weeks | by monitoring the change of amount of secretions collection calibrated tube attached to a closed suction system to calculate the secretion mass before and after treatment using: Suction by Endotracheal closed suction with pressure control ventilation (PCV) will be performed. The duration of suction was 10 s with 5-s rest for each set. Three sets of suction with a closed suction system will be used for both groups of patients. |
| weaning from mechanical ventilator | from 2 to 4 weeks | by improving previously mentioned respiratory function |
Countries
Egypt
Outcome results
None listed