Indicators of Airway Secretion Weight in Mechanically Ventilated Subjects.
BACKGROUND: Clinicians may use adventitious breath sounds on lung auscultation and a "sawtooth" pattern on the ventilator expiratory flow waveform as indicators of the need for chest physiotherapy for airway-secretion clearance in mechanically ventilated patients. This study seeks to identify potent...
| Publicado en: | Respiratory Care Vol. 64; no. 11; pp. 1377 - 1387 |
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| Autores principales: | , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Nov2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139348310&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139348310 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Nov2019 vid: 64 iid: 11 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 139348310 139348310 139348310 10.4187/respcare.06437 139348310 ppf: 1377 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Indicators of Airway Secretion Weight in Mechanically Ventilated Subjects. aug: au: Ntoumenopoulos, George Berry, Marc P. Camporota, Luigi Lam, Lawrence affil: Physiotherapy Department, St Vincent's Hospital, Sydney, Australia sug: subj: Respiration, Artificial Fluids and Secretions Analysis Airway Management Chest Physical Therapy Human Male Female Middle Age Aged England Respiratory Sounds Tidal Volume Acoustics Equipment and Supplies Technology, Medical Utilization Software Intubation, Intratracheal Physical Therapists Exploratory Research Multiple Linear Regression Descriptive Statistics Data Analysis Software Endotracheal Tubes Tracheostomy Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Clinicians may use adventitious breath sounds on lung auscultation and a "sawtooth" pattern on the ventilator expiratory flow waveform as indicators of the need for chest physiotherapy for airway-secretion clearance in mechanically ventilated patients. This study seeks to identify potential clinical and novel indicators of the weight of airway secretions cleared from a single session of chest physiotherapy in mechanically ventilated subjects. METHODS: We recorded airway crackles using artificial airway acoustic sound monitoring and computerized lung-sound amplitude using artificial airway acoustic sound detection and compared them to standard clinical assessments in 71 mechanically ventilated subjects immediately prior to a single session of chest physiotherapy. Correlational analyses were undertaken between the weight of airway secretions obtained after the single session of chest physiotherapy as the dependent variable and novel assessments, clinical assessments, patient characteristics, and ventilator parameters as the independent variables. Multiple linear regression analyses were then used to determine the best model to predict the weight of airway secretions obtained from the single chest physiotherapy session. Data are reported as mean and median as appropriate. Significance was set at P < .05. RESULTS: 71 mechanically ventilated subjects were included for analysis. Statistically significant associations with the weight of airway secretions included the presence of a sawtooth waveform on expiration and the novel assessment of average airway crackles during inspiration. The best predictive model of the weight of airway secretions included the presence of the sawtooth waveform on expiration and ventilator tidal volume. CONCLUSIONS: Simple clinical assessments used in this study were able to independently predict the weight of airway secretions cleared during a single session of chest physiotherapy. The novel assessments used in this investigation did not add any further value. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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