OBJECTIVE: To compare the effects of mechanical insufflation-exsufflation vs. suctioning via tracheostomy tubes on respiratory variables for six amyotrophic lateral sclerosis patients. DESIGN: In this prospective crossover study, six consecutive patients with amyotrophic lateral sclerosis who required continuous mechanical ventilation via tracheostomy tubes and developed chest infections underwent measurement of pulse oxyhemoglobin saturation (SpO2), peak inspiratory pressure (PIP), mean airway pressure (Pawm), and work of breathing performed by the ventilator (WOBv) at baseline and 5 and 30 min after tracheal suctioning and 5 min after mechanical insufflation-exsufflation. RESULTS: The baseline values were 93.50 +/- 2.26% for SpO2 in ambient air, 18.50 +/- 4.23 cm H2O for PIP, 4.67 +/- 1.37 cm H2O for Pawm, and 1.03 +/- 0.25 J/liters for WOBv. Only WOBv changed significantly, decreasing after tracheal suctioning (P < 0.05), whereas all variables improved significantly after mechanical insufflation-exsufflation. CONCLUSION: For ventilator-dependent patients with amyotrophic lateral sclerosis, mechanical insufflation-exsufflation via a tracheostomy tube with an inflated cuff may be more effective in eliminating airway secretions than conventional tracheal suctioning.
RCT Entities:
OBJECTIVE: To compare the effects of mechanical insufflation-exsufflation vs. suctioning via tracheostomy tubes on respiratory variables for six amyotrophic lateral sclerosispatients. DESIGN: In this prospective crossover study, six consecutive patients with amyotrophic lateral sclerosis who required continuous mechanical ventilation via tracheostomy tubes and developed chest infections underwent measurement of pulse oxyhemoglobin saturation (SpO2), peak inspiratory pressure (PIP), mean airway pressure (Pawm), and work of breathing performed by the ventilator (WOBv) at baseline and 5 and 30 min after tracheal suctioning and 5 min after mechanical insufflation-exsufflation. RESULTS: The baseline values were 93.50 +/- 2.26% for SpO2 in ambient air, 18.50 +/- 4.23 cm H2O for PIP, 4.67 +/- 1.37 cm H2O for Pawm, and 1.03 +/- 0.25 J/liters for WOBv. Only WOBv changed significantly, decreasing after tracheal suctioning (P < 0.05), whereas all variables improved significantly after mechanical insufflation-exsufflation. CONCLUSION: For ventilator-dependent patients with amyotrophic lateral sclerosis, mechanical insufflation-exsufflation via a tracheostomy tube with an inflated cuff may be more effective in eliminating airway secretions than conventional tracheal suctioning.
Authors: W Darlene Reid; Jennifer A Brown; Kristin J Konnyu; Jennifer M E Rurak; Brodie M Sakakibara Journal: J Spinal Cord Med Date: 2010 Impact factor: 1.985
Authors: William M Coutinho; Paulo J C Vieira; Fernanda M Kutchak; Alexandre S Dias; Marcelo M Rieder; Luiz Alberto Forgiarini Journal: Indian J Crit Care Med Date: 2018-07
Authors: Miguel Sánchez-García; Passio Santos; Gema Rodríguez-Trigo; Fernando Martínez-Sagasti; Tomás Fariña-González; Ángela Del Pino-Ramírez; Carlos Cardenal-Sánchez; Beatriz Busto-González; Mónica Requesens-Solera; Mercedes Nieto-Cabrera; Francisco Romero-Romero; Antonio Núñez-Reiz Journal: Intensive Care Med Exp Date: 2018-04-03