Effects of Ventilator Hyperinflation Versus Vibrocompression in Mechanically Ventilated Patients
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Ventilator Hyperinflation, Vibrocompression, Traditional Chest Physical Therapy Program.
- Who it may be relevant to
- Registry conditions: Mechanically Ventilated Patients, Lung Compliance, Airway Clearance Impairment. Basic parameters: 35 years — 55 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effects of Ventilator Hyperinflation Versus Vibrocompression on Lung Compliance in Mechanically Ventilated Patients
Overview
The aim of the current study is to compare the effects of ventilator hyperinflation and vibrocompression on lung compliance in mechanically ventilated patients.
Detailed description
Lower respiratory infections remained the world's most deadly communicable disease, ranked as the 4th leading cause of death.
The aim of mechanical ventilation is to reduce the ventilatory work and maintain gas exchange, but it also has deleterious effects on mucociliary transport and coughing ability. These effects provoke the stasis of secretions in the airways and bronchial obstruction, with hypoventilation, atelectasis, and consequent hypoxemia. This set of factors also favors microorganism multiplication and, thus, an increased incidence of ventilator-associated pneumonia (VAP), impaired gas exchange, pulmonary infection and fibrosis, and progressive reduction of lung compliance. To reverse or reduce these deleterious effects, bronchial hygiene techniques are used by physical therapists in several ICUs around the world. Among these techniques, tracheal aspiration, vibrocompression (VB), and hyperinflation with mechanical ventilation are commonly employed.
Lung compliance is inversely proportional to elastance. This elastic resistance is due to the elastic property of lung tissue or parenchyma and the surface elastic force. Any changes occurring to these forces could lead to changes in compliance. Compliance determines 65% of the work of breathing. If the lung has low compliance, it requires more work from breathing muscles to inflate the lungs. In specific pathologies, continuous monitoring of the lung compliance curve is useful to understand the condition's progression and to decide on therapeutic settings needed for ventilator management So, the current study will help to determine the effects of ventilator hyperinflation and vibrocompression on lung compliance and sputum production in mechanically ventilated patients.
Interventions
- Other Ventilator Hyperinflation
In ventilator hyperinflation volume control mode, the ventilator will be set to eight breaths per minute, and the tidal volume will be increased to deliver hyperinflation breaths that are 15 ml/kg, as will be calculated using the predicted body weight. Tidal volume will be increased in 150-ml increments until a peak airway pressure of 40 cmH2O is achieved. Once this pressure is reached, eight mechanical breaths will be delivered to the patient. After this, the ventilator will be reset to pretrea - Other Vibrocompression
Vibrocompression will be performed by the physical therapist to produce vibration and will be combined with compression of the patient's chest in the expiratory phase. Every vibrocompression will be interrupted at the end of each expiratory phase to allow free inspiration. - Other Traditional Chest Physical Therapy Program
Percussion, Postural Drainage, and Suction
Primary outcome measures
- Static Compliance [Time frame: Before, after treatment at Day 1 and Day 4]
- Airway Resistance [Time frame: Before, after treatment at Day 1 and Day 4]
- Sputum Volume in ml [Time frame: Immediately after treatment at Day 1 and Day 4]
- Peak Expiratory Flow and Peak Inspiratory Flow [Time frame: Before, after treatment at Day 1 and Day 4]
Secondary outcome measures (1)
- Oxygen Saturation (SPO2) [Time frame: Before, after treatment at Day 1 and Day 4]
Eligibility criteria
Inclusion criteria
- Eighty-one mechanically ventilated patients more than 48 hours up to 7 days
- Their ages range from 35 to 55 years old.
- Medical stability (mean arterial pressure > 60 < 110, systolic blood pressure > 80, diastolic blood pressure > 60, fraction of inspired oxygen < 60, positive end expiratory pressure (PEEP) <10)
Exclusion criteria
Patients will be excluded if they have the following conditions or diseases:
- Unstable hemodynamics
- Fraction of inspired oxygen (FiO2) ≥ 0.6
- PEEP ≥ 10 cmH2O
- undrained pneumothorax and hemothorax or subcutaneous emphysema
- Pulmonary pathology (e.g., acute respiratory distress syndrome, exacerbation of chronic obstructive pulmonary disease, and acute pulmonary edema)
- Unstable neurological problems (raised intracranial pressure).
- Lung Cancer
- Recent/unhealed rib fracture
- Any disease obstructs our study.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Egypt · 1 center
- Kasr AL Ainy — Cairo
Identifiers
NCT: NCT06791798 · P.T.REC/012/005560