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...

Descripción completa

Detalles Bibliográficos
Publicado en:Respiratory Care Vol. 64; no. 11; pp. 1377 - 1387
Autores principales: Ntoumenopoulos, George, Berry, Marc P., Camporota, Luigi, Lam, Lawrence
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Nov2019
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