Efficacy and Ventilatory Responses to VHI in Atelectasis Patients
Atelectasis
About this trial
This is an interventional treatment trial for Atelectasis focused on measuring lung collapse, ventilator hyper inflation, hemodynamic responses, ventilatory responses, trauma patients
Eligibility Criteria
Inclusion Criteria:
- Critical trauma patients with pulmonary complications who were intubated and mechanical ventilation and have a diagnosis of lobar atelectasis and/or plate-like atelectasis (atelectasis demonstrated on chest X-ray) will be considered for inclusion. For the sign of plate-like atelectasis will be persist on chest X-ray for 2 day
- The injuries may occur alone or combination of these injuries: 1) head injury, 2) chest injuries, including broken ribs, with or without hemothorax, pneumothorax and hemopneumothorax with intercostal chest drainage (ICD), 3) blunt abdominal, and 4) fracture of the limbs and/or spine.
Exclusion Criteria:
- acute respiratory distress syndrome (ARDS)
- acute lung injury (ALI)
- pulmonary contusion
- undrained pneumothorax, hemothorax, and hemopneumothorax
- bronchospasm
- pulmonary bullae/blebs
- lung tumors
- lung abscess
- haemoptysis
- mean arterial pressure (MAP) <70 mmHg
- positive end expiratory pressure (PEEP) >6 cmH2O
- heart rate (HR) >140 beats/min
- blood pressure (BP) <90/60 or >180/100 mmHg
- restlessness
- oxygen saturation (SpO2) <90%
- spontaneous respiratory rate (RR) >35 beats/min
Sites / Locations
- Khon Kaen University
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Control group
Experimental group
All of the participants in control group will be treated with conventional treatment for 3 days, The conventional treatments consist of: (1) Passive chest mobilization, (2) Positioning, (3) Side lying (good lung down), (4) Vibration. The conventional treatment consists of three consecutive periods; (1) baseline period: 10 minutes, (2) intervention period, and (3) recovery period: 10 minutes.
All of the participants of the experimental group will be treated with ventilator hyperinflation technique (VHI) for 3 days. Tidal volume will increase from baseline (100% VT) to the tidal volume target at 1.5 times (150% VT). At this level, patients will receive six breathes and in each breathe will be sustained for 5 second (6 hyperinflation breathe per set); expiratory VT will return to baseline after each breath. Four sets of hyperinflation breathing will be used. After this, VT will decrease to baseline and patients have a 60 second for rest between hyperinflation set. The ventilator hyperinflation technique (VHI) consists of three consecutive periods; (1) baseline period: 10 minutes, (2) intervention period, and (3) recovery period: 10 minutes.