Comparison of Three Technical Airway Clearance in Mechanical Ventilated Patients

Study Overview
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Brief Summary
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Randomized clinical trial, conducted in the Intensive Care Unit of the Hospital de Clinicas de Porto Alegre from october 2011 until november 2015 .

Detailed Description
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Objective: To compare the effectiveness of techniques: vibrocompression (G1), hyperinflation with mechanical ventilation (G2) vibrocompression + hyperinflation with mechanical ventilation (G3) in the amount of aspirated secretions, mechanical ventilator time, incidence of ventilator-associated pneumonia , reintubation tracheal and mortality in mechanical ventilator. Primary outcome: weight in grams of the aspirated secretions. Secondary outcome: hemodynamic and pulmonary parameters: heart rate, respiratory rate, mean arterial pressure, peripheral arterial oxygen saturation; peak inspiratory pressure, tidal volume; dynamic compliance ; mechanical ventilator time; reintubation tracheal; Incidence of ventilator-associated pneumonia and mortality in mechanical ventilator.

Official Title
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Comparison of Three Technical Airway Clearance in Mechanical Ventilated Patients

Conditions
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Mucociliary Clearance Defect, Physical Disability

Intervention / Treatment
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* Other: Vibrocompression (VB)
* Other: Hyperinflation (HMV)
* Other: HMV+VB


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: In mechanical ventilation for a period of 24-72 h End-expiratory pressure (PEEP) lower 10 cm of water. Lower noradrenaline doses of 0.5mg / kg / minute for an average greater than or equal blood outstrips 60 mmHg. Exclusion Criteria: Pneumothorax and hemothorax undrained Subcutaneous emphysema Osteoporosis Acute respiratory distress syndrome - (ARDS) Fractures of ribs Obese ( BMI greater than 35) Mechanical ventilator with higher peak pressures 40 cm of water.

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

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Vibocompression (VB)<br>Grup 1 - Vibrocompression: Is a physical therapy technique, that aims to clear the airways of patients on mechanical ventilation. Through the thoracic compression during expiration | Other: Vibrocompression (VB)<br>* Vibrocompression is a physical therapy technique, that aims to clear the airways of patients on mechanical ventilation (MV)<br>* Other names: Techinique of physical therapy;|
| Active Comparator: Hyperinflation (HMV)<br>Grup 2 - Hyperinflation with Mechanical ventilator: Is a physical therapy technique, that aims to clear the airways of patients on mechanical ventilation. Through the increase in inspiratory pressure ventilator . | Other: Hyperinflation (HMV)<br>* Hyperinflation technique with mechanical ventilator which aims to clear the airways of patients on mechanical ventilation<br>* Other names: Techinique of physical therapy;|
| Experimental: HMV+VB<br>Grup 3 - Hyperinflation with mechanical ventilator and vibrocompression:Is a physical therapy technique, that aims to clear the airways of patients on mechanical ventilation. Through the thoracic compression during expiration and the increase in inspiratory pressure ventilator. | Other: HMV+VB<br>* Association between Vibrocompression and Hyperinflation with mechanical ventilator<br>* Other names: Techinique of physical therapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight in grams of the pulmonary secretions |  | up to 24 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time mechanical ventilator (MV) in days |  | Through study completion, an average of 3 years. | 
| Reintubation tracheal in percentage in the last 24 hours |  | Through study completion, an average of 3 years. | 
| Incidence of ventilator-associated pneumonia in percentage |  | Through study completion, an average of 3 years. | 
| Mortality in the MV in percentage |  | Through study completion, an average of 3 years. | 
| Heart Rate |  | up to 24 weeks. | 
| Respiratory frequency |  | up to 24 weeks | 
| Peripheral oxygen saturation in percentage |  | up to 24 weeks | 
| Tidal volume in milliliters |  | up to 24 weeks | 
| Peak inspiratory pressure in centimeters of water |  | up to 24 weeks |