RT Journal Article
SR Electronic
T1 Effects of Mechanical Insufflation-Exsufflation on Airway Mucus Clearance Among Mechanically Ventilated ICU Subjects
JF Respiratory Care
FD American Association for Respiratory Care
SP 1471
OP 1477
DO 10.4187/respcare.06253
VO 63
IS 12
A1 Ferreira de Camillis, Márcio Luiz
A1 Savi, Augusto
A1 Goulart Rosa, Regis
A1 Figueiredo, Mariana
A1 Wickert, Ricardo
A1 Borges, Luis Guilherme Alegretti
A1 Galant, Lucas
A1 Teixeira, Cassiano
YR 2018
UL http://rc.rcjournal.com/content/63/12/1471.abstract
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. (ClinicalTrials.gov registration NCT03178565.)