Thoracic Diseases
Conditions
Keywords
Thoracic surgery, Chest tubes, Chest wall oscillation, Physical therapy modalities, Postoperative care, Airway Clearance Techniques
Brief summary
This study was conducted to determine the effects of a manual vibration technique applied to the chest wall on the duration of chest tube placement, secretion clearance, and hemodynamic parameters in patients with chest tubes.
Detailed description
This study was conducted to determine the effects of a manual vibration technique applied to the chest wall on the duration of chest tube placement, secretion clearance, and hemodynamic parameters in patients with chest tubes. Thoracic surgery is a method used in the treatment of diseases of the lungs, pleura, chest wall, and mediastinum. The primary problems encountered by patients postoperatively include improper patient positioning, incision pain, ineffective coughing, reduced lung volume, postoperative pulmonary complications, inadequate airway clearance, frozen shoulder on the side of the thoracotomy, postural abnormalities, and persistent chest wall tension. These issues, particularly pulmonary complications, can delay patient recovery, prolong hospital stays, and increase morbidity and mortality. Tube thoracostomy is a one-way drainage system that facilitates the drainage of fluid and air from the pleural space, maintains negative pressure, and allows for lung expansion. Additionally, it allows for the administration of therapeutic medications into the pleural space. Patients should be educated on respiratory exercises-such as coughing, balloon inflation, and the use of a triflowmeter-to facilitate lung expansion and secretion clearance, and they should be encouraged to perform these exercises regularly. A review of the literature reveals no studies investigating the effectiveness of manual vibration in patients with chest tubes. It is believed that this technique may shorten the duration of chest tube placement. Additionally, due to the lack of cost-effectiveness of mechanical vibration, supply issues, the inability to use it effectively on all patients in clinical settings, the recommendation for more frequent use, and the necessity of applying it based on the patient's needs rather than at regular intervals (such as every two hours)-a determination that must be made by the nurse closely monitoring the patient- it is anticipated that the manual vibration technique will provide greater benefits at regular intervals without incurring additional costs, as it adapts to the patient's needs and the clinic's operational schedule throughout the day.
Interventions
PROCEDUREChest Wall Oscillation
Manual chest wall vibration is applied with the patient in a semi-Fowler's position during the expiratory phase of breathing. The practitioner places both hands flat on the chest wall and delivers gentle, rhythmic vibrations, starting from the lower lobes and progressing toward the upper lobes. Patients are instructed to inhale slowly through the nose and exhale using a pursed-lip breathing technique with a 1:2 inspiration-expiration ratio. The procedure is performed for approximately 5 minutes, corresponding to about 10 respiratory cycles, and is typically applied during the patient's rest period following routine care.
BEHAVIORALConventional Control
Control group patients were informed about the study and provided written consent. They received only routine nursing care, with no additional interventions applied. Baseline measurements were taken at 0 minutes, including dyspnea (MBS), pain (VNRS), vital signs, and arterial blood gas values. Following routine care, the same parameters were reassessed at 3, 5, and 10 minutes and recorded. No manual chest wall vibration was performed; only standard clinical monitoring was maintained. The same assessment protocol was repeated in the evening session.
Sponsors
Saglik Bilimleri Universitesi
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Conventional control group will have regular nursing cares and outcome assessments will be performed by a investigator who was blinded to group allocation.
Intervention model description
Two groups with a conventional control group
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Having undergone thoracic surgery * Having a chest tube in the postoperative period * Being hemodynamically stable * Agreeing to participate in the study * Being open to communication and cooperation
Exclusion criteria
* Severe cardiac instability * Patients unable to tolerate the procedure due to neurological or cognitive impairment * Clinical conditions that would prevent the application of vibration to the chest wall * Patients diagnosed with pneumonia * Patients with a newly implanted transvenous or subcutaneous pacemaker
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Follow-Up Form | 1 day | Changes in respiratory and hemodynamic parameters (including respiratory rate, peripheral oxygen saturation, heart rate, blood pressure), dyspnea severity (Modified Borg Scale), and pain intensity (Visual Numeric Rating Scale) measured before the intervention and at 0, 1, 5, 10, and 15 minutes after the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-Operative Respiratory Status Questionnaire | 1 day | A 6-item patient-reported questionnaire using a 5-point Likert scale will be used to assess postoperative respiratory symptoms and adherence to breathing exercises. Higher scores indicate better outcomes. |
| Questionnaire on manual chest wall vibration therapy | 1 day | A 9-item Likert-type questionnaire will be used to assess patient comfort, perceived benefit, and satisfaction with manual chest wall vibration. Higher scores indicate more favorable outcomes. |
Countries
Turkey (Türkiye)
Contacts
CONTACTBeyza SU, MSc.
CONTACTSibel YİLMAZ SAHİN, Assoc Prof
STUDY_DIRECTORSibel YILMAZ SAHİN, Assoc Prof
Institute of Health Sciences, Saglik Bilimleri University
PRINCIPAL_INVESTIGATORBeyza SU, MSc.
Institute of Health Sciences, Saglik Bilimleri University
Outcome results
None listed