Effect of Thoracic Block Technique on Arterial Blood Gases in Children With Atelectasis on Mechanical Ventilation

Study Overview
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Brief Summary
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Statement of the problem: • Does the thoracic block technique has effect on arterial blood gases, vital signs and lung compliance in children with atelectasis on mechanical ventilation? Null hyposis there is no effect of thoracic block technique on arterial blood gases, vital signs and lung compliance in children with atelectasis on mechanical ventilation.

Detailed Description
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Subjects: The study targets the children from both sexes.diagnosed with atelectasis in intensive care unit. Sample size estimation will be carried out to determine the recruited number of children, selected randomly from Cairo University pediatric specialized hospital, Cairo to participate in the study, Study design: Randomized controlled clinical trial. Children will receive intervention type randomly, 22 child received percussion, vibration, modified postural drainage and the other 22 child will receive percussion, vibration, modified postural drainage and thoracic block technique. Children will be assessed by measuring heart rate, respiratory rate,which reflect the physiological status, arterial blood gases which include partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2) and oxygen saturation (SaO2) and dynamic lung compliance which reflect clinical improvement of chest condition before and after ten days of receiving intervention

Official Title
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Effect of Thoracic Block Technique on Arterial Blood Gases, Vital Signs and Lung Compliance in Children With Atelectasis on Mechanical Ventilation

Conditions
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Atelectasis, Intensive Care Unit, Children

Intervention / Treatment
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* Other: Thoracic block technique
* Other: Designed chest physical therapy program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age range from 4 months to 4 years. diagnosed with pneumonia, receiving mechanical ventilation. start from second day of admission to intensive care unit have unilateral mild to moderate atelectasis according to medical referral. should be vitally stable during the session. Exclusion Criteria: The children were excluded from the study if they had one of the following: medically unstable ( examples: tachycardia and tachypnea) uncontrolled convulsion. rib fracture. pneumothorax -

Ages Eligible for Study
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Minimum Age: 4 Months
Maximum Age: 4 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: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Thoracic block technique and designed chest physical therapy program<br>Manual compression on healthy lung for 20 seconds and rest for 20 seconds, total time 20 minutes and percussion, vibration and modified postural drainage on session time for 35 minutes every day for ten days | Other: Thoracic block technique<br>* Manual compression of the healthy lung during expiration associated with the use of invasive or non invasive mechanical ventilation<br>* Other names: Technique of insufflation to reverse atelectasis;|
| Active Comparator: Designed chest physical therapy program<br>Percussion, vibration and modified postural drainage for 30 minutes every day for ten days | Other: Designed chest physical therapy program<br>* Percussion, vibration and modified postural drainage<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of oxygenation status | Assessment of change of partial pressure of arterial oxygen which is one value in arterial blood gases test results which calculated by arterial blood gases analyzier and comparing results before and after intervention | 10 days for each participant | 
| Assessment of ventilation status | Assessment of change of partial pressure of carbon dioxide which is one value of arterial blood gases test results and calculated by arterial blood gases analyzier before and after intervention | 10 days for each participant | 
| Assessment of dynamic lung compliance | Assessment of change in lung compliance value during air flow which calculated automatically by mechanical ventilator, we record it before and after intervention | 10 days for each participant |