Efficacy and Ventilatory Responses to VHI in Atelectasis Patients

Khon Kaen University

Status: Completed

Conditions: Atelectasis

Treatments: Procedure: Ventilator hyperinflation technique; Procedure: Conventional treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT02768350

VHI-efficacy-atelectasis

Details and patient eligibility

About

The purpose of this study include (1) To investigate the efficacy of ventilator hyperinflation technique to re-expand lung atelectasis on patients with critical trauma who intubated and mechanical ventilation in the intensive care unit, (2) To investigate the effectiveness of ventilator hyperinflation technique to improve airway clearance on patients with critical trauma in the intensive care unit, and (3) To explore the acute responses of ventilatory functions to ventilator hyperinflation technique on patients with critical trauma who intubated and mechanical ventilation in the intensive care unit.

Enrollment: 30 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Critical trauma patients with pulmonary complications who were intubated and mechanical ventilation and have a diagnosis of lobar atelectasis and/or plate-like atelectasis (atelectasis demonstrated on chest X-ray) will be considered for inclusion. For the sign of plate-like atelectasis will be persist on chest X-ray for 2 day
• The injuries may occur alone or combination of these injuries: 1) head injury, 2) chest injuries, including broken ribs, with or without hemothorax, pneumothorax and hemopneumothorax with intercostal chest drainage (ICD), 3) blunt abdominal, and 4) fracture of the limbs and/or spine.

Exclusion criteria

• acute respiratory distress syndrome (ARDS)
• acute lung injury (ALI)
• pulmonary contusion
• undrained pneumothorax, hemothorax, and hemopneumothorax
• bronchospasm
• pulmonary bullae/blebs
• lung tumors
• lung abscess
• haemoptysis
• mean arterial pressure (MAP) <70 mmHg
• positive end expiratory pressure (PEEP) >6 cmH2O
• heart rate (HR) >140 beats/min
• blood pressure (BP) <90/60 or >180/100 mmHg
• restlessness
• oxygen saturation (SpO2) <90%
• spontaneous respiratory rate (RR) >35 beats/min

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Control group

Experimental group

Description:

All of the participants in control group will be treated with conventional treatment for 3 days, The conventional treatments consist of: (1) Passive chest mobilization, (2) Positioning, (3) Side lying (good lung down), (4) Vibration. The conventional treatment consists of three consecutive periods; (1) baseline period: 10 minutes, (2) intervention period, and (3) recovery period: 10 minutes.

Treatment:

Procedure: Conventional treatment

Experimental group

Experimental group

Description:

All of the participants of the experimental group will be treated with ventilator hyperinflation technique (VHI) for 3 days. Tidal volume will increase from baseline (100% VT) to the tidal volume target at 1.5 times (150% VT). At this level, patients will receive six breathes and in each breathe will be sustained for 5 second (6 hyperinflation breathe per set); expiratory VT will return to baseline after each breath. Four sets of hyperinflation breathing will be used. After this, VT will decrease to baseline and patients have a 60 second for rest between hyperinflation set. The ventilator hyperinflation technique (VHI) consists of three consecutive periods; (1) baseline period: 10 minutes, (2) intervention period, and (3) recovery period: 10 minutes.

Treatment:

Procedure: Ventilator hyperinflation technique