Effect of Lung Volume Recruitment Technique After Extubation

NCT05128552 | Completed

• 1 other identifier: LVR in ICU
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

This study was conducted to investigate the effect of the LVR technique on cough ineffectiveness, to determine its benefit as a simple, safe, and inexpensive cough augmentation technique, and to determine how much the LVR method, for augmenting CPF, is useful in enhancing the success of extubation and reducing the rate of reintubation.

Conditions

Mechanical Ventilation Complication; Diaphragm Issues; Cough; Ineffective Airway Clearance; Intensive Care Unit Acquired Weakness

Keywords

Cough peak flow; Lung volume recruitment; Air stacking; Cough efficacy; Post extubated patient; Respiratory therapy; Intensive care unit; Mechanical ventilation

Outcome Measures

Primary Outcomes (3)

• Cough peak flow rate

  The maximum expiratory flow produced immediately after the glottis opens during a physiological cough

  "Day 4"

• Peak expiratory flow rate

  The maximum rate at which the air can be expired after a deep inspiration

  "Day 4"

• Oxygen Saturation

  The percentage that represents how haemoglobin are saturated with oxygen atoms

  "Day 4"

Secondary Outcomes (1)

• Extubation's success

  "Day 4"

Study Arms (2)

Study group

EXPERIMENTAL

Twenty-five patients who received traditional chest physiotherapy and LVR technique for 30-45 minutes for successive 4 Days after extubation

Device: Lung volume recruitment technique; Other: Traditional chest physiotherapy

Control group

ACTIVE COMPARATOR

Twenty-five patients who received only traditional chest physiotherapy for 30 minutes at least for successive 4 Days after extubation

Other: Traditional chest physiotherapy

Interventions

Lung volume recruitment technique DEVICE

A self inflating Ambu bag with one way valve , augmentation volume of air within 3 to 4 successive breaths and holding few seconds then coughing

Also known as: Air stacking or breath stacking technique

Study group

Traditional chest physiotherapy OTHER

Positioning of the patient according the drainage position for each lobe of each lung and applying airway hygiene techniques such as percussion and vibration

Control group; Study group

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Forty to sixty years old patients had undergone mechanical ventilation for ≥ 48 hours in a controlled mode and had been weaned after a successful spontaneous breathing trial with suboptimal or poor CPF \< 270 L/min.
• Patients were able to assume a sitting position.
• All participants were aware, cooperative, competent, able to comply with treatment, and able to understand and follow instructions.

You may not qualify if:

• Presence of significant or active hemoptysis, untreated or recent pneumothorax, bullous emphysema, lung trauma, or recent lobectomy.
• Patients with comorbidities interfering and compromising the success of either weaning or extubation, like cardiac arrhythmia, pericardial effusion, congestive heart failure, or acute coronary syndrome.
• Patients who had originally inadequate training performance of the respiratory muscle such as those having NMD, i.e., myopathy or neuropathy.
• Impaired consciousness/inability to communicate.
• Patients who had a neurological deficit resulted in bulbar affection.
• Patients with indications for MV, but contraindicated for physical therapy like pulmonary embolism.
• Patients who had undergone tracheotomy before extubation also were excluded or who had experienced less than 24 hours of mechanical ventilation.
• Patients with unstable hemodynamics or cardiac instability.
• Current undrained pleural effusion or previous pneumothorax or barotrauma.
• Uncontrolled severe COPD, poorly controlled asthma, and severe bronchospasm.
• Patients with visual or/and auditory problems.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of physical therapy Cairo University

Cairo, Giza Governorate, Egypt

Location

Related Publications (2)

• Rose L, Adhikari NK, Leasa D, Fergusson DA, McKim D. Cough augmentation techniques for extubation or weaning critically ill patients from mechanical ventilation. Cochrane Database Syst Rev. 2017 Jan 11;1(1):CD011833. doi: 10.1002/14651858.CD011833.pub2.

  PMID: 28075489 BACKGROUND

• Rose L, Adhikari NK, Poon J, Leasa D, McKim DA; CANuVENT Group. Cough Augmentation Techniques in the Critically Ill: A Canadian National Survey. Respir Care. 2016 Oct;61(10):1360-8. doi: 10.4187/respcare.04775. Epub 2016 Sep 13.

  PMID: 27624630 BACKGROUND

MeSH Terms

Conditions

Cough

Condition Hierarchy (Ancestors)

Respiration Disorders; Respiratory Tract Diseases; Signs and Symptoms, Respiratory; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Mahmoud S. Ragab, Bsc

  Cairo University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ICU Physical Therapist

Study Record Dates

• First Submitted: October 29, 2021
• First Posted: November 22, 2021
• Study Start: December 15, 2020
• Primary Completion: September 1, 2021
• Study Completion: October 1, 2021
• Last Updated: November 22, 2021

Record last verified: 2021-11

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)