Expiratory Rib Cage Compression in Mechanically Ventilated Patients
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ClinicalTrials.gov Identifier: NCT01525121 |
Recruitment Status
:
Completed
First Posted
: February 2, 2012
Last Update Posted
: February 2, 2012
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Pulmonary Infection | Other: Expiratory Rib Cage Compression | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 20 participants |
Allocation: | Randomized |
Intervention Model: | Crossover Assignment |
Masking: | Single (Investigator) |
Primary Purpose: | Treatment |
Official Title: | Expiratory Rib Cage Compression Does Not Improve Secretion Clearance and Respiratory Mechanics in Mechanically Ventilated Patients |
Study Start Date : | July 2008 |
Actual Primary Completion Date : | June 2009 |
Actual Study Completion Date : | June 2009 |
Arm | Intervention/treatment |
---|---|
Experimental: Expiratory Rib Cage Compression
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.
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Other: Expiratory Rib Cage Compression
The therapist hands were positioned on the lower ribs, and the force was applied every two breaths only during the expiration, synchronizing the maneuver rate with the patient's respiratory rate. Then, the patients underwent a suctioning procedure, and a hyperinflation maneuver consisting of a 10 minutes period under pressure support ventilation of 35 cmH2O was done. In control intervention instead of the compressive maneuver the patients were kept on normal ventilation.
Other Name: Manual thoracic compression
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No Intervention: 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.
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- Sputum Volume (mL) [ Time Frame: Day 1 ]
- Respiratory Mechanics [ Time Frame: Day 1 ]Static and effective compliance of the respiratory system Total resistance of the respiratory system

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Ages Eligible for Study: | 19 Years to 90 Years (Adult, Senior) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
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.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01525121
Brazil | |
Centro Universitário Augusto Motta | |
Rio de Janeiro, Brazil, 21041-010 |
Study Chair: | Fernando S Guimarães, PhD | Centro Universitário Augusto Motta | |
Principal Investigator: | Sara LS Menezes, PhD | Centro Universitário Augusto Motta | |
Principal Investigator: | Agnaldo J Lopes, PhD | Centro Universitário Augusto Motta |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Fernando Silva Guimaraes, Associate Professor, Centro Universitário Augusto Motta |
ClinicalTrials.gov Identifier: | NCT01525121 History of Changes |
Other Study ID Numbers: |
MTC_MV |
First Posted: | February 2, 2012 Key Record Dates |
Last Update Posted: | February 2, 2012 |
Last Verified: | February 2012 |
Keywords provided by Fernando Silva Guimaraes, Centro Universitário Augusto Motta:
mechanical ventilation chest physiotherapy critical care pneumonia Mechanically ventilated patients with pulmonary infection. |