Effect of Rib Mobilization on Weaning Parameters From Mechanical Ventilator in Patients With Pneumonia

Overview

this study will be conducted to distinguish between effect of rib mobilization and routine chest physiotherapy on weaning parameters from mechanical ventilator in patients with pneumonia • HYPOTHESES: It will be hypothesized that there may be significant effect of rib mobilization on weaning parameters from mechanical ventilator in patients with pneumonia. RESEARCH QUESTION: Does rib mobilization have an effect on weaning parameters from mechanical ventilator in patients with pneumonia? measuring weaning parameters: on screen of mechanical ventilator : measuring respiratory rate, Tidal volume (TV), FiO2. * Arterial blood gases (ABG) analyzer machine ABG is recorded daily (PH- PaO2 - PaCO2) * Length of ICU stay: calculated by (admission date - discharge date * Weaning success rate

Detailed description

Ventilator-associated pneumonia (VAP) represents a significant sub-set of (HAP) remains the most frequent intensive care unit (ICU)-acquired infection its incidence ranges from 9% to 27% of ventilated patients ,VAP is associated with an increased length of stay, mortality and health care costs, Pneumonia can result in chest wall stiffness, decreased mobility, limiting the range of motion during breathing and decreased lung compliance and impaired respiratory function , Rib mobilization: is an articular , non-invasive, passive technique that can be useful with acutely ill, hospitalized patients emphasizes the placement of a repetitive force to increase the range of motion of the posterior rib articulations and chest wall , lessening somatic dysfunction of the spine, stretches myofascial structures and improve respiratory mechanics So, this study will be conducted to distinguish between effect of rib mobilization and routine chest physiotherapy on weaning parameters among intubated pneumonic patients on mechanical vent.

Interventions

• Other rib mobilization technique
  rib mobilization technique The patient in experimental group will be relaxed in semi- fowler position while connected to mechanical ventilator, therapist will seat at the patient "side, his fingers pads are placed at the position of the patient's rib angles , pulling upward and the lateral position the position is held while wait for the soft tissues to release this take from 15 seconds .Release of the diaphragm through manual contact with hypothenar region of therapist thumb inferior laterally
• Other routine chest physiotherapy
  routine chest physiotherapy the patient will be laid in half supine position connected to a ventilator applying * percussion on chest wall its frequency should be 3-7 beats per second or 180-420 beats per minute * vibration applying a light pressure with flattened hand on affected segment for about 5 minutes * modified postural drainage (right and left sidling 10 min for each side * upper and lower limb exercise for 4 limbs (3 sets and each set has 10 repetition * this program for 30 minutes on

Primary outcome measures

• Arterial blood gases [Time frame: at least 10 consecutive days]
• Respiratory rate (RR) [Time frame: at least 10 consecutive days]
• Tidal volume (TV) [Time frame: at least 10 consecutive days]

Secondary outcome measures (1)

• Length of hospital stay [Time frame: at least 10 consecutive days]

Eligibility criteria

Inclusion criteria

• Patient's age ranged from 40- 50 years old from both genders.
• Diagnosed with pneumonia and need invasive mechanical ventilation support.
• Stable oxygen saturation (SpO2 more than 85, (FiO2) 0.6 or less, PEEP less than 10 Cm H2O).
• mean arterial pressure > 75 mmHg and urine output > 1 mL/kg/h;
• Patients with Glasgow coma scale (GCS) > 8T
• Unconscious and semi-conscious patients. -

Exclusion criteria

• Unstable hemodynamics
• Unstable neurological problems e.g. (epileptic seizures -hyperthermia).
• Unstable chest wall e.g. (multiple rib or vertebral fractures)
• Increase intracranial pressure (>20 mmHg for >5 min).
• Undrained pneumothorax, recent pulmonary surgery

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

• El Galaa Military Hospital — Cairo

Identifiers

NCT: NCT06835842 · PT REC/012/005446

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗