Pressure Support During Chest Wall Compression

Study Overview
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Brief Summary
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The purpose of this study is to compare two physiotherapy techniques: chest wall compression versus chest wall compression plus increase of 10 cmH2O in inspiratory pressure.

Detailed Description
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After being placed in the supine position in bed, with head angle elevation at 30°, patients were randomized to:group 1 (G1): chest wall compression for ten minutes in chest or group 2 (G2): chest wall compression plus increase of 10 cmH2O in IP in PSV for ten minutes in chest. Clinical variables and APACHE II were registered. Parameters analyzed at the beginning (1) and at the end (2) of the protocol were: variation of peak pressure (ΔPp=Pp2-Pp1),variation of tidal volume (ΔVT =VT2-VT1), variation of dynamic compliance (ΔCdyn= Cdyn2-Cdyn1). The amount of variation of mucus secretion aspirated (ΔSa= Sa2-Sa1) at the end was also measured

Official Title
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Increasing Pressure Support During Chest Wall Compression is Useful During Respiratory Therapy?

Conditions
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Respiration, Artificial, Critical Care

Intervention / Treatment
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* Device: Chest wall compression plus increase of 10 cmH2O in inspiratory pressure during Pressure Support Ventilation for ten minutes in chest.
* Device: Chest wall compression for ten minutes in chest


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients on mechanical ventilation over 48 hours With ventilatory drive Hemodynamically stable MAP> 60 mmHg With treatment of respiratory therapy Exclusion Criteria: Contra indication of increased positive inspiratory pressure Peak pressure in the upper airway > 40 cmH2O Osteoporosis diagnosis Deny to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PSV group.<br>Chest wall compression plus increase of 10 cmH2O of PSV. | Device: Chest wall compression plus increase of 10 cmH2O in inspiratory pressure during Pressure Support Ventilation for ten minutes in chest.<br> <br> |
| Active Comparator: chest wall compression group<br>Chest wall compression | Device: Chest wall compression for ten minutes in chest<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Variation of mucus secretion aspirated. |  | Two years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hemodynamic and pulmonary parameters. | The hemodynamic and pulmonary parameters were collected: Hart rate (HH), respiratory rate (f), mean arterial pressure (MAP) and peripheral arterial saturation of oxygen (SpO2); peak inspiratory pressure (Ppeak),and Tidal volume (VT) measured in the ventilator, dynamic compliance (Cdyn calculated through the formula VT/ Ppeak - PEEP) | Two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mechanical ventilation, Chest physiotherapy, Chest wall compression