Document Detail


Increasing pressure support does not enhance secretion clearance if applied during manual chest wall vibration in intubated patients: a randomised trial.
MedLine Citation:
PMID:  21402326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
QUESTIONS: What is the effect of increasing pressure support during the application of manual chest wall compression with vibrations for secretion clearance in intubated patients in intensive care?
DESIGN: A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis.
PARTICIPANTS: 66 patients receiving mechanical ventilation for greater than 48 hours.
INTERVENTION: All participants were positioned supine in bed with the backrest elevated 30 degrees. The experimental group received manual chest wall compression with vibrations during which their pressure support ventilation was increased by 10 cm H(2)O over its existing level. The control group received manual chest wall compression with vibrations but no adjustment of the ventilator settings. Both groups then received airway suction.
OUTCOME MEASURES: The primary outcome was the weight of the aspirate. Secondary outcomes were pulmonary and haemodynamic measures and oxygenation.
RESULTS: Although both treatments increased the weight of the aspirate compared to baseline, the addition of increased pressure support during manual chest wall compression with vibrations did not significantly increase the clearance of secretions, mean between-group difference in weight of the aspirate 0.4 g, 95% CI -0.5 to 1.4. Although several other measures also improved in one or both groups with treatment, there were no significant differences between the groups for any of the secondary outcomes.
CONCLUSION: Although increasing pressure support has previously been shown to increase secretion clearance in intubated patients, the current study did not show any benefits when it was added to chest wall compression with vibrations.
TRIAL REGISTRATION: NCT01155648.
Authors:
Wagner da Silva Naue; Ana Carolina Texeira da Silva; Adriana Meira Güntzel; Robledo Leal Condessa; Roselaine Pinheiro de Oliveira; Silvia Regina Rios Vieira
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of physiotherapy     Volume:  57     ISSN:  1836-9553     ISO Abbreviation:  J Physiother     Publication Date:  2011  
Date Detail:
Created Date:  2011-03-15     Completed Date:  2011-04-07     Revised Date:  2012-08-22    
Medline Journal Info:
Nlm Unique ID:  101528691     Medline TA:  J Physiother     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  21-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.
Affiliation:
Division of Critical Care Medicine, Clínicas Hospital Brazil. wnaue@hcpa.ufrgs.br
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01155648
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Chest Wall Oscillation / methods*
Chronic Disease
Female
Humans
Intensive Care / methods
Intubation, Intratracheal*
Lung Diseases / mortality,  therapy*
Male
Middle Aged
Mucus / secretion
Outcome Assessment (Health Care)
Oxygen / blood
Pressure
Respiration, Artificial*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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