Ventilator Hyperinflation and Manual Rib Cage Compression

NCT03630484 | Completed

• 1 other identifier: VHI + Rib Cage Compression
• Study Type: interventional
• Target: 30
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Pulmonary Atelectasis

Keywords

Ventilator Hyperinflation; Expiratory Rib Cage Compression; Physical Therapy; Mechanical Ventilation

Outcome Measures

Primary Outcomes (4)

• Static compliance of respiratory system

  Compliance was assessed through the occlusion maneuver at the end of inspiration, considering tidal volume, plateau pressure and PEEP. Three measurements were taken at each moment, the mean being used.

  Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration

• Total Resistance of respiratory system

  The total resistance of the respiratory system was evaluated through the occlusion maneuver at the end of the inspiration, considering the resistive pressure, measured by the difference between the maximum plateau pressure. Three measurements were taken at each moment, the mean being used.

  Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration

• Airway Resistance

  The airway resistance was assessed by means of the occlusion maneuver at the end of the inspiration, considering the rapid fall of the pressure immediately after the occlusion, measured by the difference between the maximum pressure and P1. Three measurements were taken at each moment, the mean being used.

  Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration

• Peak expiratory flow

  The peak expiratory flow was evaluated through passive expiration, being considered the greatest value of the flow in the expiratory phase.

  Baseline (before), immediately after ventilator hyperinflation or rib cage compression and five minutes after aspiration

Study Arms (2)

Expiratory Rib Cage Compression

ACTIVE COMPARATOR

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

Other: Expiratory Rib Cage Compression

Compression + Ventilator Hyperinflation

ACTIVE COMPARATOR

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.

Other: Compression + Ventilator Hyperinflation

Interventions

Expiratory Rib Cage Compression OTHER

Compression was performed in 6 sets of 6 cycles, with 1 cycle interval. Ventilatory mode and parameters were maintained.

Expiratory Rib Cage Compression

Compression + Ventilator Hyperinflation OTHER

Mechanical ventilator hyperinflation was performed by increasing the inspiratory pressure to every 5 cmH2O until the total pressure reached 40 cmH2O, remaining the same. In Expiratory Rib Cage Compression associated with ventilator hyperinflation, thoracic compression maneuver was performed at the end of inspiration, at the exact moment of cycling.

Compression + Ventilator Hyperinflation

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

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

Sponsors & Collaborators

• Brazilian Institute of Higher Education of Censa: lead

MeSH Terms

Conditions

Pulmonary Atelectasis

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases

Study Officials

• LUCIANO M CHICAYBAN, MSc

  Brazilian Institute of Higher Education of Censa

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 6, 2018
• First Posted: August 15, 2018
• Study Start: November 28, 2014
• Primary Completion: December 5, 2014
• Study Completion: July 11, 2017
• Last Updated: August 15, 2018

Record last verified: 2018-08

Data Sharing

• IPD Sharing: Will not share