دورية أكاديمية
Effects of mechanical insufflation-exsufflation on sputum volume in mechanically ventilated critically ill subjects
| العنوان: | Effects of mechanical insufflation-exsufflation on sputum volume in mechanically ventilated critically ill subjects |
|---|---|
| المؤلفون: | Martínez-Alejos, Roberto, Martí, Joan Daniel, Li Bassi, Gianluigi, Gonzalez-Anton, Daniel, Pilar-Diaz, Xabier, Reginault, Thomas, Wibart, Philippe, Ntoumenopoulos, George, Tronstad, Oystein, Gabarrus, Albert, Quinart, Alice, Torres, Antoni |
| المصدر: | Respiratory Care |
| بيانات النشر: | Daedalus Enterprises Inc. |
| سنة النشر: | 2021 |
| المجموعة: | Queensland University of Technology: QUT ePrints |
| مصطلحات موضوعية: | Mechanical insufflation-exsufflation, Mechanical ventilation, Physiotherapy, Pulmonary mechanics, Sputum clearance |
| الوصف: | BACKGROUND: Mechanical insufflation-exsufflation (MI-E) is a noninvasive technique performed to simulate cough and remove sputum from proximal airways. To date, the effects of MI-E on critically ill patients on invasive mechanical ventilation are not fully elucidated. In this randomized crossover trial, we evaluated the efficacy and safety of MI-E combined to expiratory rib cage compressions (ERCC). METHODS: Twenty-six consecutive subjects who were sedated, intubated, and on mechanical ventilation > 48 h were randomized to perform 2 sessions of ERCC with or without additional MI-E before tracheal suctioning in a 24-h period. The primary outcome was sputum volume following each procedure. Secondary end points included effects on respiratory mechanics, hemodynamics, and safety. RESULTS: In comparison to ERCC alone, median (inter-quartile range) sputum volume cleared was significantly higher during ERCC+MI-E (0.42 [0–1.39] mL vs 2.29 [1–4.67] mL, P < .001). The mean 6 SD respiratory compliance improved in both groups immediately after the treatment, with the greater improvement in the ERCC+MI-E group (54.7 6 24.1 mL/cm H 2 O vs 73.7 6 35.8 mL/cm H 2 O, P < .001). Differences between the groups were not significant (P 5 .057). Heart rate increased significantly in both groups immediately after each intervention (P < .05). Additionally, a significant increase in oxygenation was observed from baseline to 1 h post-intervention in the ERCC+MI-E group (P < .05). Finally, several transitory hemodynamic variations occurred during both interventions, but these were nonsignificant and were considered clinically irrelevant. CONCLUSIONS: In mechanically ventilated subjects, MI-E combined with ERCC increased the sputum volume cleared without causing clinically important hemodynamic changes or adverse events. (ClinicalTrials.gov registration: NCT03316079.). |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | Martínez-Alejos, Roberto, Martí, Joan Daniel, Li Bassi, Gianluigi, Gonzalez-Anton, Daniel, Pilar-Diaz, Xabier, Reginault, Thomas, Wibart, Philippe, Ntoumenopoulos, George, Tronstad, Oystein, Gabarrus, Albert, Quinart, Alice, & Torres, Antoni (2021) Effects of mechanical insufflation-exsufflation on sputum volume in mechanically ventilated critically ill subjects. Respiratory Care, 66(9), pp. 1371-1379.; https://eprints.qut.edu.au/230565Test/; Faculty of Engineering; School of Mechanical, Medical & Process Engineering |
| الإتاحة: | https://doi.org/10.4187/respcare.08641Test https://eprints.qut.edu.au/230565Test/ |
| رقم الانضمام: | edsbas.3F0188F8 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |