To Assess the Effectiveness of Three Distinct Mechanical Assisted Sputum Evacuation Apparatuses in the Treatment of Patients With Mechanical Ventilation-induced Atelectasis

Retention of airway secretions is a common clinical problem in patients with mechanical ventilation. Effective removal of airway secretions requires a balance between the production and removal of airway secretions through the mucociliary transport system. Effective removal of airway secretions is the basic measure to maintain airway patency and normal alveolar ventilation and oxygenation. At present, a variety of mechanical assisted expectoration devices have been used to remove airway secretions in critically ill patients, including The MetaNeb® System(MetaNeb), High Frequency Chest Wall Oscillation(HFCWO) and (Cycloid Vibration Therapy)CVT. However, there is still a lack of sufficient evidence to evaluate the clinical efficacy of these three different mechanical assisted expectoration devices in airway management of patients with mechanical ventilation. This study aims to observe the clinical efficacy of three different mechanical assisted sputum evacuation devices in airway management of patients with mechanical ventilation atelectasis, and to provide a basis for optimizing the airway management scheme of patients with mechanical ventilation.

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Key information

Conditions

Mechanical Ventilation Atelectasis Lung Diseases Pulmonary Atelectasis Respiratory Tract Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Who can participate

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

≥18 years old.
patients who were diagnosed as obstructed airway secretion clearance and required mechanical sputum evacuation in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Among them, patients using CVT were included in the CVT cohort, patients using Metaneb were included in the Metaneb cohort, and patients using high-frequency chest wall oscillation (HFCWO) were included in the high-frequency chest wall oscillation (HFCWO) cohort.
voluntarily participated in this study and signed the informed consent. If the subjects were unable to read and sign the informed consent form due to incapacity or other reasons, their guardians were required to act for them during the informed consent process and sign the informed consent form. If the subjects were unable to read the informed consent form (e.g., illiterate subjects), witnesses were required to witness the informed consent process and sign the informed consent.
Invasive mechanical ventilation ≥48 hours.
Atelectasis was confirmed by chest CT, chest X-ray or lung ultrasound.

Exclusion criteria

BMI≥40kg/m2.
Severe spinal and thoracic deformity.
Known or suspected diaphragmatic dysfunction such as phrenic nerve rupture, neuromuscular disease, etc.
untreated tension pneumothorax.
Active bleeding in the lung.
Severe hemodynamic instability (increased dose of vasoactive drugs within 2 hours or MAP≤65mmHg).
Severe other organ dysfunction was expected to result in short-term death (7 days) or palliative treatment.
Other reasons considered by the medical team not suitable for treatment.
Pregnancy status.

Treatment and study plan

CVT

Device

During mechanical ventilation, patients with atelectasis confirmed by chest CT, chest X-ray or lung ultrasound should be treated with mechanical assisted sputum evacuation, and the mechanical assisted sputum evacuation equipment used is CVT.

HFCWO

Device

MetaNeb

Device

Primary outcomes

CT

Time frame: From enrollment to the end of treatment at 5 days

3D Slicer 5.0.3 software was used to import the chest CT data set, which consisted of 1.25mm thick continuous CT slices obtained by a multi-slice spiral CT scanner under a conventional dose protocol (120Kv,150mA, pitch 1.0), and then the ''Lung CT Segment'' extension program was used. The lung regions were segmented by manually marking 13 marker points. After marking, all the lung regions were visually displayed, and then the region range was manually corrected using the tools selected in the ''Segment editor''. The ''Lung CT Analyzer'' extension program was then used to quantify the lung zones of ''hyperventilation'', ''normal ventilation'', ''hypoventilation'', and ''no ventilation'', and the proportion of no ventilation areas was obtained by software analysis.

Study contacts

Contact information is provided by the study sponsor or research team.

Yang Limin Yang

CONTACT

[email protected]

18268076196

Sponsors and collaborators

Lead sponsor

Sir Run Run Shaw Hospital

Other

Registry information

Official study title

Evaluation of the Effectiveness of Mechanically Assisted Sputum Excretion

Acronym: EOTEOMASE

Important dates

Study start: 2024
Primary completion: 2025
Study completion: 2025
First posted: Oct 8, 2024
Registry last updated: Oct 8, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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