| Trendelenburg chest optimization prolongs spontaneous breathing trials in ventilator-dependent patients with low cervical spinal cord injury. | |
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MedLine Citation:
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PMID: 20665351 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Chest optimization, an evidence-based protocol-guided multimodal chest physiotherapy consisting of body positioning, sputum mobilization, bronchodilation, and lung hyperinflation, may be routinely administered to ventilator-dependent patients with low cervical spinal cord injury (CSCI) for improving pulmonary functional outcomes that facilitate weaning from mechanical ventilation. We undertook this study to determine whether position-specific chest optimization was associated with changes in spontaneous breathing trial (SBT) duration. Cardiac output (CO), alveolar minute volume (MValv), carbon dioxide elimination (VCO(2)), and static chest compliance (Cst) were measured during chest optimization; then MValv and rapid shallow breathing index (RSBI) were measured during SBT. Study participants (N = 12) were clinically stable ventilator-dependent patients with low CSCI. Trendelenburg chest optimization (TCO) was associated with significant increases in SBT (p < 0.001), CO (p < 0.001), MValv (p < 0.003), VCO(2) (p < 0.001), and Cst (p < 0.002). SBT following TCO was associated with significant increases in MValv (p < 0.03) and RSBI (p < 0.002). These preliminary findings suggest the importance of proper recumbent body positioning during evidence-based, protocol-guided multimodal chest physiotherapy for ventilator-dependent patients with low CSCI. |
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Authors:
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Charles J Gutierrez; Cathy Stevens; John Merritt; Cecille Pope; Mihaela Tanasescu; Glenn Curtiss |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of rehabilitation research and development Volume: 47 ISSN: 1938-1352 ISO Abbreviation: J Rehabil Res Dev Publication Date: 2010 |
Date Detail:
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Created Date: 2010-07-28 Completed Date: 2010-11-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8410047 Medline TA: J Rehabil Res Dev Country: United States |
Other Details:
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Languages: eng Pagination: 261-72 Citation Subset: IM |
Affiliation:
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Department of Respiratory Care & Diagnostic Services, James A. Haley Veterans Hospital, Tampa, FL 33612, USA. charles.gutierrez@va.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Breath Tests Cross-Over Studies Device Removal / methods Double-Blind Method Evidence-Based Medicine Florida Head-Down Tilt / physiology* Hospitals, Veterans Humans Intensive Care Units Intubation, Intratracheal Male Middle Aged Respiration, Artificial Spinal Cord Injuries / rehabilitation*, therapy Supine Position / physiology* Time Factors Treatment Outcome Ventilator Weaning / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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