Ventilator Hyperinflation and Manual Rib Cage Compression

Brazilian Institute of Higher Education of Censa

Status: Completed

Conditions: Pulmonary Atelectasis

Treatments: Other: Expiratory Rib Cage Compression; Other: Compression + Ventilator Hyperinflation

Study type: Interventional

Funder types: Other

Identifiers

NCT03630484

VHI + Rib Cage Compression

Details and patient eligibility

About

This is a randomized crossover trial to evaluate the effects of thoracic compression applied alone or in association with hyperinflation maneuver with the ventilator. In addition, the mobilized volume and peak expiratory flow resulting from both maneuvers will be evaluated.

Full description

Ventilator hyperinflation is widely used in hypersecretive patients. It consists of increasing alveolar ventilation by facilitating the coughing mechanism so that the secretions of the peripheral airways are mobilized into the central airways so that they can be removed by tracheal aspiration or cough. Thoracic compression consists of manually compressing the rib cage during expiration, in order to increase expiratory flow, mobilize and remove pulmonary secretions. A randomized crossover clinical trial was performed with 30 patients submitted to isolated compression or associated with ventilator hyperinflation, with a 6 hour interval. Patients were evaluated through compliance and resistance of the respiratory system.

Enrollment: 30 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients under mechanical ventilation
• diagnosis of pulmonary infection
• hypersecretive

Exclusion criteria

• haemodynamic instability (heart rate > 130 bpm and mean arterial pressure < 60 mmHg)
• acute bronchospasm
• acute respiratory distress syndrome
• untreated pneumothorax

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Expiratory Rib Cage Compression

Active Comparator group

Description:

Expiratory rib cage compression was performed in 6 sets of 6 cycles, with 1 cycle interval. Ventilatory mode and parameters were maintained.

Treatment:

Other: Expiratory Rib Cage Compression

Compression + Ventilator Hyperinflation

Active Comparator group

Description:

Expiratory rib cage compression was performed in 6 sets of 6 cycles, with 1 cycle interval. Ventilator hyperinflation was performed by increasing the inspiratory pressure to every 5 cmH2O until the total pressure reached 40 cmH2O, remaining the same.

Treatment:

Other: Compression + Ventilator Hyperinflation