Effects of Mechanical Insufflation-Exsufflation on Airway Mucus Clearance Among Mechanically Ventilated ICU Subjects.

BACKGROUND: Few studies have evaluated the effects of mechanical insufflation-exsufflation (MI-E) in subjects on mechanical ventilation. Therefore, this study aimed to evaluate the effectiveness of MI-E on airway mucus clearance among mechanically ventilated ICU subjects. METHODS: A randomized, para...

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Publicado en:Respiratory Care Vol. 63; no. 12; pp. 471 - 478
Autores principales: Ferreira de Camillis, Márcio Luiz, Savi, Augusto, Rosa, Regis Goulart, Figueiredo, Mariana, Wickert, Ricardo, Borges, Luis Guilherme Alegretti, Galant, Lucas, Teixeira, Cassiano
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Mary Ann Liebert, Inc. Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Effects of Mechanical Insufflation-Exsufflation on Airway Mucus Clearance Among Mechanically Ventilated ICU Subjects.
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          Ferreira de Camillis, Márcio Luiz
          Savi, Augusto
          Rosa, Regis Goulart
          Figueiredo, Mariana
          Wickert, Ricardo
          Borges, Luis Guilherme Alegretti
          Galant, Lucas
          Teixeira, Cassiano
        affil: Intensive Care Unit, Hospital Moinhos de Vento, Porto Alegre, Brazil
      sug:
        subj:
          Insufflation Equipment and Supplies
          Airway Management Methods
          Respiratory Therapy Methods
          Respiration, Artificial Adverse Effects
          Mucociliary Clearance
          Critically Ill Patients
          Treatment Outcomes
          Human
          Randomized Controlled Trials
          Random Assignment
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Descriptive Statistics
          Fisher's Exact Test
          Wilcoxon Rank Sum Test
          Data Analysis Software
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: BACKGROUND: Few studies have evaluated the effects of mechanical insufflation-exsufflation (MI-E) in subjects on mechanical ventilation. Therefore, this study aimed to evaluate the effectiveness of MI-E on airway mucus clearance among mechanically ventilated ICU subjects. METHODS: A randomized, parallel-group, open-label trial was conducted between June and November 2017 in a single, mixed ICU. Adult ICU subjects receiving mechanical ventilation for > 24 h with stable ventilatory and hemodynamic status were randomized to receive either standard respiratory physiotherapy alone (control group) or respiratory physiotherapy by using an MI-E device (intervention group). The primary outcome was the weight of aspirated airway mucus after study interventions. Secondary outcomes included variation in static lung compliance (ΔCL), airway resistance (ΔRaw), work of breathing (ΔWOB) in relation to the pre-intervention period, and hemodynamic and ventilator complications during the procedures. RESULTS: There were 90 subjects in each group. The mean ± SD weight of the aspirated airway mucus was higher in the intervention group than in the control group (2.42 ± 2.32 g vs 1.35 ± 1.56 g, P < .001). The ΔCL values in the intervention group were higher than those in the control group (1.76 ± 4.90 mL/cm H2O vs -0.57 ± 4.85 mL/cm H2O, P = .001). The ΔRaw and ΔWOB values were similar between the groups. No hemodynamic or ventilatory complications were observed. CONCLUSIONS: Among the general ICU subjects receiving mechanical ventilation, use of an MI-E device during respiratory physiotherapy resulted in a larger amount of airway mucus clearance than respiratory physiotherapy alone.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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