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Completed

NCT Number: NCT03630484

Ventilator Hyperinflation and Manual Rib Cage Compression

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.

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Key information

Conditions

Pulmonary Atelectasis Lung Diseases Respiratory Tract Diseases

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Ventilator hyperinflation is widely used in hypersecretive patients. It consists of increasing alveolar ventilation by facilitating the coughing mechanism so that the secretions of the peripheral airways are mobilized into the central airways so that they can be removed by tracheal aspiration or cough. Thoracic compression consists of manually compressing the rib cage during expiration, in order to increase expiratory flow, mobilize and remove pulmonary secretions. A randomized crossover clinical trial was performed with 30 patients submitted to isolated compression or associated with ventilator hyperinflation, with a 6 hour interval. Patients were evaluated through compliance and resistance of the respiratory system.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

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

Exclusion criteria

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

Treatment and study plan

expiratory rib cage compression

Other

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

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.

Primary outcomes

  1. Static compliance of respiratory system

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

    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.

  2. Total Resistance of respiratory system

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

    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.

  3. Airway Resistance

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

    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.

  4. Peak expiratory flow

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

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

Sponsors and collaborators

Lead sponsor

Brazilian Institute of Higher Education of Censa

Other

Registry information

Official study title

Comparison Between Ventilator Hyperinflation and Manual Rib Cage Compression: Randomized Crossover Trial

Important dates

Study start
2014
Primary completion
2014
Study completion
2017
First posted
Aug 15, 2018
Registry last updated
Aug 15, 2018

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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