Expiratory Rib Cage Compression in Mechanically Ventilated Patients
Pulmonary Infection
About this trial
This is an interventional treatment trial for Pulmonary Infection focused on measuring mechanical ventilation, chest physiotherapy, critical care, pneumonia, Mechanically ventilated patients with pulmonary infection.
Eligibility Criteria
Inclusion Criteria:
- patients under mechanical ventilation
- diagnosis of pulmonary infection
- hypersecretive (defined as the interval between tracheal suctioning < 2 hours)
Exclusion Criteria:
- haemodynamic instability (defined by heart rate > 130 bpm and mean arterial pressure < 60 mmHg)
- use of vasopressor drugs
- absence of respiratory drive
- acute bronchospasm
- acute respiratory distress syndrome
- atelectasis (identified by an independent radiologist that was not participating in the study)
- untreated pneumothorax
- lung haemorrhage.
Sites / Locations
- Centro Universitário Augusto Motta
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Expiratory Rib Cage Compression
Control
This a crossover study, so all subjects performed both, control and experimental interventions. The patients were kept in supine at 30 degree head-up position. Ventilatory mode was changed to volume-controlled, with a tidal volume of 8mL/kg, inspiratory flow of 60 Lpm and positive end expiratory pressure (PEEP) of 5 cmH2O. A first tracheal suctioning was done, and the mucus was discarded. Then, a series of two minutes of bilateral expiratory rib-cage compressions ensued. Aiming to minimize inter-therapist variability, the maneuver was applied by the same registered and trained physiotherapist. Control intervention followed the same sequence, but instead of the compressive maneuver they were kept on normal ventilation with the parameters described above.
This a crossover study, so all subjects performed both, control and experimental interventions. The patients were kept in supine at 30 degree head-up position. Ventilatory mode was changed to volume-controlled, with a tidal volume of 8mL/kg, inspiratory flow of 60 Lpm and positive end expiratory pressure (PEEP) of 5 cmH2O. A first tracheal suctioning was done, and the mucus was discarded. Then, a series of two minutes of bilateral expiratory rib-cage compressions ensued. Aiming to minimize inter-therapist variability, the maneuver was applied by the same registered and trained physiotherapist. Control intervention followed the same sequence, but instead of the compressive maneuver they were kept on normal ventilation with the parameters described above.