QUESTION: Is ventilator-induced hyperinflation in sidelying more effective than sidelying alone in removing secretions and improving respiratory mechanics in ventilated patients with pulmonary infection? DESIGN: Randomised crossover trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS: 30 mechanically ventilated patients with pulmonary infection in an adult intensive care unit. INTERVENTION: The experimental intervention was 30 minutes of ventilator-induced hyperinflation using pressure support ventilation in sidelying; the control intervention was 30 minutes of sidelying. Participants received both interventions on the same day, with a five-hour washout period between them. OUTCOME MEASURES: Secretion clearance was measured as sputum volume retrieved during the intervention. Respiratory mechanics were measured as static compliance and total resistance of the respiratory system before and after the intervention. RESULTS: The experimental intervention cleared 1.3 ml (95% CI 0.5 to 2.2) more secretions than the control. After ventilator-induced hyperinflation in sidelying, respiratory compliance had increased 4.7 ml/cmH(2)O (95% CI 2.6 to 6.8) more than in sidelying alone. There was no difference in total resistance of the respiratory system between the interventions (mean difference 0.3 cmH(2)O/l/s, 95% CI -0.8 to 1.3). CONCLUSION: The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.
RCT Entities:
QUESTION: Is ventilator-induced hyperinflation in sidelying more effective than sidelying alone in removing secretions and improving respiratory mechanics in ventilated patients with pulmonary infection? DESIGN: Randomised crossover trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS: 30 mechanically ventilated patients with pulmonary infection in an adult intensive care unit. INTERVENTION: The experimental intervention was 30 minutes of ventilator-induced hyperinflation using pressure support ventilation in sidelying; the control intervention was 30 minutes of sidelying. Participants received both interventions on the same day, with a five-hour washout period between them. OUTCOME MEASURES: Secretion clearance was measured as sputum volume retrieved during the intervention. Respiratory mechanics were measured as static compliance and total resistance of the respiratory system before and after the intervention. RESULTS: The experimental intervention cleared 1.3 ml (95% CI 0.5 to 2.2) more secretions than the control. After ventilator-induced hyperinflation in sidelying, respiratory compliance had increased 4.7 ml/cmH(2)O (95% CI 2.6 to 6.8) more than in sidelying alone. There was no difference in total resistance of the respiratory system between the interventions (mean difference 0.3 cmH(2)O/l/s, 95% CI -0.8 to 1.3). CONCLUSION: The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.
Authors: Wagner da Silva Naue; Bruno Barcelos Herve; Fernando Nataniel Vieira; Gracieli Nadalon Deponti; Luciane de Fraga Martins; Alexandre Simões Dias; Silvia Regina Rios Vieira Journal: Rev Bras Ter Intensiva Date: 2019-03-14
Authors: Wagner da Silva Naue; Bruno Barcelos Herve; Fernando Nataniel Vieira; Gracieli Nadalon Deponti; Luciane de Fraga Martins; Alexandre Simões Dias; Silvia Regina Rios Vieira Journal: Rev Bras Ter Intensiva Date: 2019 Oct-Dec
Authors: Eleuterio A Sánchez Romero; José Luis Alonso Pérez; Inmaculada Vinuesa Suárez; Camilo Corbellini; Jorge Hugo Villafañe Journal: SAGE Open Med Case Rep Date: 2022-07-18
Authors: Crisiela Brum Assmann; Paulo José Cardoso Vieira; Fernanda Kutchak; Marcelo de Mello Rieder; Soraia Genebra Ibrahim Forgiarini; Luiz Alberto Forgiarini Junior Journal: Rev Bras Ter Intensiva Date: 2016 Jan-Mar