Evaluating the Short-term Efficacy of Two Oscillation Techniques in Hypersecretive Mechanically Ventilated Patients

Capital Medical University

Status: Enrolling

Conditions: Hypersecretive Mechanically Ventilated Patients

Treatments: Device: High-frequency chest wall oscillation; Device: Oscillation and Lung Expansion

Study type: Interventional

Funder types: Other

Identifiers

NCT06675942

12300126

Details and patient eligibility

About

Although mechanical ventilation (MV) is life-saving, it is associated with several complications. The establishment of an artificial airway impairs the cough reflex and mucociliary function, leading to the accumulation of secretions in the tracheobronchial tree. This increases the risk of pneumonia and lung atelectasis. Usual care for mechanically ventilated patients includes airway suctioning via the tracheostomy tube, which clears only a limited portion of the airway and is ineffective at removing peripheral airway secretions.

To address this, airway clearance guidelines recommend various airway clearance techniques (ACTs) for mechanically ventilated patients to enhance mucus removal. However, the lack of standardized, effective evaluation criteria makes selecting the optimal ACT a challenge.

Full description

The aim of this randomized cross-over study was to compare the effectiveness of oscillation and lung expansion (OLE) versus high-frequency chest wall oscillation (HFCWO) on lung aeration and ventilation distribution, as assessed by EIT, in medically complex, hypersecretive patients with tracheostomy tubes requiring long-term mechanical ventilation (MV).

Enrollment: 24 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Eligible participants were patients aged ≥18 years with airway hypersecretion, admitted to the ICU,
• Requiring more than 48 hours of MV.

Exclusion criteria

• Malignant arrhythmia
• Acute myocardial ischemia
• Pneumothorax, pulmonary bulla, barotrauma, or other lung diseases,
• Hemorrhagic disease or coagulation abnormalities with bleeding tendencies
• Skin trauma on the chest
• Pulmonary embolism
• Presence of a permanent or temporary pacemaker
• Untreated spinal and rib fractures
• Any condition deemed inappropriate for study inclusion by the researchers.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Quadruple Blind

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24 participants in 2 patient groups

Oscillation and Lung Expansion

Experimental group

Treatment:

Device: Oscillation and Lung Expansion

Device: High-frequency chest wall oscillation

High-frequency chest wall oscillation

Experimental group

Treatment:

Device: Oscillation and Lung Expansion

Device: High-frequency chest wall oscillation