Clinical trial NCT05579145: Tracheal Suctioning and Expiratory Pause in Bronchial Hygiene
Official title: Effects of Combined Tracheal Suctioning and Expiratory Pause 5 or 10 Seconds: a Crossover Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Mechanical Ventilation
Keywords: Bronchial hygiene
Tracheal suctioning
Respiratory therapy
Intensive care unit
Lead sponsor: Hospital de Clinicas de Porto Alegre
Sponsor class: OTHER
First posted: 2022-10-13
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: A randomized crossover clinical trial conducted in an Intensive Care Unit of the Hospital de Clinicas de Porto Alegre (HCPA) to compare the efficacy of the two techniques on the amount of aspirated pulmonary secretion and pulmonary mechanics: aspiration of the closed system following an expiratory pause with mechanical ventilator for 5 seconds (5-Second Expiratory Pause) and aspiration of the closed system following an expiratory pause with mechanical ventilator for 10 seconds (10-Second Expiratory Pause).

Detailed description: After randomization, all patients will be positioned in dorsal decubitus with the head elevated at 30 degrees and will be aspirated once with a closed suction system and with a vacuum of -40cm H2O. Hemodynamic and pulmonary parameters will be collected and recorded. One of the two techniques will be applied, according to randomization, and the outcomes measured. After two hours, hemodynamic and pulmonary parameters will be re-collected, and the second technique will be applied. The outcomes will be measured again.

Eligibility criteria: Inclusion Criteria:

* Patients in 24 and 72 hours of mechanical ventilation.
* Patients with closed aspiration system.
* Patients hemodynamically stable (mean arterial blood pressure ≥ 60 mmHg and with dose of Noradrenaline ≤ 1μg/kg/minute).

Exclusion Criteria:

* Undrained pneumothorax and hemothorax.
* Subcutaneous emphysema.
* Patients who refuse to participate in the study.

Primary outcomes:
measure: Weight of secretion aspirated (grams)
timeFrame: Immediately after the application of one of the closed system aspiration techniques.
Secondary outcomes:
measure: Peripheral arterial oxygen saturation (SpO2) (%)
timeFrame: One minute after the application of the studied technique.
measure: Peak inspiratory pressure (PIP) (cm H2O)
timeFrame: One minute after the application of the studied technique.
measure: End expiratory pressure (PEEP) (cmH2O)
timeFrame: One minute after the application of the studied technique.
measure: Air trapping (AUTO-PEEP) (cmH2O)
timeFrame: One minute after the application of the studied technique.
measure: Mechanical ventilation circuit pressure (cmH2O)
timeFrame: One minute after the application of the studied technique.
measure: Tidal volume (TV) (ml)
timeFrame: One minute after the application of the studied technique.
measure: Endotracheal tube diameter (ETT) (mm)
timeFrame: One minute after the application of the studied technique.
measure: Dynamic compliance (Cd) (ml/cmH2O)
timeFrame: One minute after the application of the studied technique.
measure: Resistance (R) (L/s)
timeFrame: One minute after the application of the studied technique.
measure: Drive pressure (cmH2O)
timeFrame: One minute after the application of the studied technique.
measure: Heart rate (HR) (beats per minute)
timeFrame: One minute after the application of the studied technique.
measure: Respiratory rate (RR) (breaths per minute).
timeFrame: One minute after the application of the studied technique.
measure: Mean arterial pressure (MAP) (mmHg)
timeFrame: One minute after the application of the studied technique.
Other outcomes:
Locations:
city: Porto Alegre
country: Brazil
facility: Hospital de Clinicas de Porto Alegre
state: Rio Grande Do Sul
city: Porto Alegre
country: Brazil
facility: Luciane FG Martins
state: RS
Study officials:
affiliation: Hospital de Clínicas de Porto Alegre
name: Luciane FG Martins, Master
role: PRINCIPAL_INVESTIGATOR
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