Back to Search Start Over

Chest compression with a higher level of pressure support ventilation: effects on secretion removal, hemodynamics, and respiratory mechanics in patients on mechanical ventilation

Authors :
Wagner da Silva Naue
Luiz Alberto Forgiarini Junior
Alexandre Simoes Dias
Silvia Regina Rios Vieira
Source :
Jornal Brasileiro de Pneumologia, Vol 40, Iss 1, Pp 55-60 (2014)
Publication Year :
2014
Publisher :
Sociedade Brasileira de Pneumologia e Tisiologia, 2014.

Abstract

OBJECTIVE: To determine the efficacy of chest compression accompanied by a 10-cmH2O increase in baseline inspiratory pressure on pressure support ventilation, in comparison with that of aspiration alone, in removing secretions, normalizing hemodynamics, and improving respiratory mechanics in patients on mechanical ventilation. METHODS: This was a randomized crossover clinical trial involving patients on mechanical ventilation for more than 48 h in the ICU of the Porto Alegre Hospital de Clínicas, in the city of Porto Alegre, Brazil. Patients were randomized to receive aspiration alone (control group) or compression accompanied by a 10-cmH2O increase in baseline inspiratory pressure on pressure support ventilation (intervention group). We measured hemodynamic parameters, respiratory mechanics parameters, and the amount of secretions collected. RESULTS: We included 34 patients. The mean age was 64.2 ± 14.6 years. In comparison with the control group, the intervention group showed a higher median amount of secretions collected (1.9 g vs. 2.3 g; p = 0.004), a greater increase in mean expiratory tidal volume (16 ± 69 mL vs. 56 ± 69 mL; p = 0.018), and a greater increase in mean dynamic compliance (0.1 ± 4.9 cmH2O vs. 2.8 ± 4.5 cmH2O; p = 0.005). CONCLUSIONS: In this sample, chest compression accompanied by an increase in pressure support significantly increased the amount of secretions removed, the expiratory tidal volume, and dynamic compliance. (ClinicalTrials.gov Identifier:NCT01155648 [http://www.clinicaltrials.gov/])

Details

Language :
English, Portuguese
ISSN :
18063756 and 18063713
Volume :
40
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Jornal Brasileiro de Pneumologia
Publication Type :
Academic Journal
Accession number :
edsdoj.3b366407589644c0b1d925dbeb6259c3
Document Type :
article
Full Text :
https://doi.org/10.1590/S1806-37132014000100008