Chest compression with a higher level of pressure support ventilation:
effects on secretion removal,hemodynamics, and respiratory mechanics in patients on
mechanical ventilation
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Authors: | Wagner da Silva Naue Luiz Alberto Forgiarini Junior Alexandre Sim?es Dias Silvia Regina Rios Vieira |
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Abstract: | OBJECTIVE:To determine the efficacy of chest compression accompanied by a
10-cmH2O increase in baseline inspiratory pressure on pressure
support ventilation, in comparison with that of aspiration alone, in removing
secretions, normalizing hemodynamics, and improving respiratory mechanics in
patients on mechanical ventilation.METHODS:This was a randomized crossover clinical trial involving patients on mechanical
ventilation for more than 48 h in the ICU of the Porto Alegre Hospital de
Clínicas, in the city of Porto Alegre, Brazil. Patients were
randomized to receive aspiration alone (control group) or compression accompanied
by a 10-cmH2O increase in baseline inspiratory pressure on pressure
support ventilation (intervention group). We measured hemodynamic parameters,
respiratory mechanics parameters, and the amount of secretions collected.RESULTS:We included 34 patients. The mean age was 64.2 ± 14.6 years. In comparison with
the control group, the intervention group showed a higher median amount of
secretions collected (1.9 g vs. 2.3 g; p = 0.004), a greater increase in mean
expiratory tidal volume (16 ± 69 mL vs. 56 ± 69 mL; p = 0.018), and a greater
increase in mean dynamic compliance (0.1 ± 4.9 cmH2O vs. 2.8 ± 4.5
cmH2O; p = 0.005).CONCLUSIONS:In this sample, chest compression accompanied by an increase in pressure support
significantly increased the amount of secretions removed, the expiratory tidal
volume, and dynamic compliance. (ClinicalTrials.gov Identifier:{"type":"clinical-trial","attrs":{"text":"NCT01155648","term_id":"NCT01155648"}}NCT01155648
http://www.clinicaltrials.gov/]) |
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Keywords: | Physical therapy modalities Respiration Artificial Intensive care units Respiratory therapy |
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