Air Stacking Technique For Pulmonary Reexpansion

Hospital Nossa Senhora da Conceicao

Status: Enrolling

Conditions: Critical Care

Treatments: Other: Air Stacking Technique; Other: No Air Stacking Technique

Study type: Interventional

Funder types: Other

Identifiers

NCT05702411

50845721.0.0000.5530

Details and patient eligibility

About

A cross-over randomized clinical trial carried out at the Intensive Care Unit. Patients who are on mechanical ventilation for more than 24 hours will be included in the study. The following techniques will be applied: aspiration in a closed system with an expiratory pause of 10 seconds associated to hyperinflation maneuver with a mechanical ventilator with the Air Stacking technique and aspiration technique in a closed system of aspiration with an expiratory pause of 10 seconds.

Full description

After randomization, all patients will be positioned in dorsal decubitus with the head elevated at 30 degrees and will be aspirated once with a closed suction system and with a vacuum limited to 150 cmH2O.

Two hours later, hemodynamic and ventilatory parameters will be collected and recorded.

If randomized to Protocol 1 (Air Stacking technique), the aspiration technique with closed system and expiratory pause will be performed three times during a 30-second interval, with a probe of the same caliber and the same vacuum value. One ml of saline solution will be instilled in the aspiration system to washing the closed suction circuit.

Immediately after, the Air Stacking maneuvers will be performed. If Protocol 2 (No Air Stacking technique), only tracheal suction with closed system.

Hemodynamic and ventilatory parameters will be collected after 1, 10 and 30 minutes of application. The secretions aspirated into the collection flasks will then be weighed, on a precision balance, by a collaborator blinded that is not part of the study, and the weight will be transcribed to the data collect.

Enrollment: 39 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients 18 years or older
• patients on mechanical ventilation for more than 48 hours
• patients on volume or pressure controlled ventilatory mode
• patients hemodynamically stable (equal mean blood pressure or more than 60 mmHg, and dose of Norepinephrine less than 1μg / Kg / minute)
• patients whose legal representatives authorize participation in the study.

Exclusion criteria

• undrained pneumothorax and hemothorax, and emphysema subcutaneous
• fracture of ribs
• ventilatory parameters with peak pressure greater than 40 cm/H2O

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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39 participants in 2 patient groups

Protocol 1

Experimental group

Description:

Closed system aspiration with an expiratory pause of 10 seconds followed by hyper insufflation maneuver with the Air Stacking technique.

Treatment:

Other: Air Stacking Technique

Protocol 2

Experimental group

Description:

Closed system aspiration with an expiratory pause of 10 seconds.

Treatment:

Other: No Air Stacking Technique