Ignite Creation Date:
2024-05-06 @ 7:54 PM
Last Modification Date:
2024-10-26 @ 3:16 PM
Study NCT ID:
NCT06182553
Status:
NOT_YET_RECRUITING
Last Update Posted:
2023-12-27
First Post:
2023-11-26
Brief Title:
Effect of ERCC andor PEEP-ZEEP Maneuver on Oxygenation Ventilation and Airway Secretions Removal in MV Patients
Sponsor:
Damanhour University
Organization:
Damanhour University
Study Overview
Official Title:
Effect of Expiratory Rib Cage Compression andor PEEP-ZEEP Maneuver on Oxygenation Ventilation and Airway Secretions Removal in Mechanically Ventilated Patients
Status:
NOT_YET_RECRUITING
Status Verified Date:
2023-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Mechanical ventilation MV is crucial in managing respiratory insufficiency However prolonged use can cause complications Various strategies have been explored to optimize patient outcomes
Patients receiving IMV face multiple challenges in clearing lung secretions such as inadequate humidification high oxygen fractions use of sedativesanalgesics basal lung disease and mechanical interference with secretion elimination near the trachea Airway suctioning may not be sufficient in clearing the airway of mechanically ventilated patients especially if they are paralyzed or lack a preserved cough reflex This can lead to secretion retention which may cause hypoxemia atelectasis ventilator-associated pneumonia and delay weaning from MV Bronchial hygiene is believed to improve respiratory system compliance by increasing Cdyn and Cst
Airway clearance techniques are commonly used in the treatment of patients with IMV to improve their pulmonary function through bronchial clearance expansion of collapsed lung areas and balancing of the ventilationperfusion ratio Physiotherapy methods including postural drainage manual rib-cage compression MRC manual hyperinflation positive end-expiratory pressure-zero end-expiratory pressure PEEP-ZEEP maneuver and tracheal suctioning can alleviate atelectasis and improve bronchial hygiene
Two effective techniques for improving lung function and gas exchange are Expiratory Rib Cage Compression ERCC and the PEEP-ZEEP maneuver ERCC applies external pressure during expiration and PEEP-ZEEP temporarily reduces Positive End-Expiratory Pressure PEEP to 0 cmH2O followed by a rapid return to the original PEEP level during expiration Both techniques help to mobilize and remove airway secretions ultimately improving lung function and gas exchange
Patients receiving IMV face multiple challenges in clearing lung secretions such as inadequate humidification high oxygen fractions use of sedativesanalgesics basal lung disease and mechanical interference with secretion elimination near the trachea Airway suctioning may not be sufficient in clearing the airway of mechanically ventilated patients especially if they are paralyzed or lack a preserved cough reflex This can lead to secretion retention which may cause hypoxemia atelectasis ventilator-associated pneumonia and delay weaning from MV Bronchial hygiene is believed to improve respiratory system compliance by increasing Cdyn and Cst
Airway clearance techniques are commonly used in the treatment of patients with IMV to improve their pulmonary function through bronchial clearance expansion of collapsed lung areas and balancing of the ventilationperfusion ratio Physiotherapy methods including postural drainage manual rib-cage compression MRC manual hyperinflation positive end-expiratory pressure-zero end-expiratory pressure PEEP-ZEEP maneuver and tracheal suctioning can alleviate atelectasis and improve bronchial hygiene
Two effective techniques for improving lung function and gas exchange are Expiratory Rib Cage Compression ERCC and the PEEP-ZEEP maneuver ERCC applies external pressure during expiration and PEEP-ZEEP temporarily reduces Positive End-Expiratory Pressure PEEP to 0 cmH2O followed by a rapid return to the original PEEP level during expiration Both techniques help to mobilize and remove airway secretions ultimately improving lung function and gas exchange
Detailed Description:
Expiratory rib cage compression is a form of chest physiotherapy that involves squeezing the chest with the hands during expiration and releasing it at the end of expiration to aid in the mobilization of lung secretions facilitate comfortable inspiration and promote alveolar ventilation The concept of manual chest compression was first explored in the 1950s when Opie et al proposed that local chest compression produces a toothpaste effect which helps to expel the retained material through the bronchus This phenomenon piqued the interest of other researchers leading to a better understanding of the functioning of the mucous layer and the development of therapeutic strategies to improve it
This technique increases forced expiratory volume by 30 and leads to the resting of the expiratory muscles Most of all the technique is quite safe as it has been employed in some patients for more than 3 years with no complications Therefore this technique can be used before the patients endotracheal suctioning interventions and it is widely used with mechanically ventilated patients to prevent andor to treat atelectasis In addition removing secretion is essential because accumulated secretions intervene in gas exchange and may delay recovery coughing can be initiated voluntarily or by reflex
The positive end-expiratory pressure-zero end-expiratory pressure maneuver considers that by raising PEEP to 15 cmH2O during five cycles followed by an abrupt reduction of PEEP to 0 cmH2O gas redistribution occurs through collateral ventilation Subsequently small airways are opened and the adhered mucus is displaced With the reduction of PEEP the expiratory flow pattern is modified causing the secretions located in smaller airways to be transported to the central airways
While many studies have looked at the effects of rib cage compression RCC or the PEEP-ZEEP maneuver individually there is a need for comparative studies that directly compare these two techniques Understanding the different effects of these interventions on oxygenation ventilation and airway-secretion removal can help critical care nurses CCNs choose the most effective strategy for mechanically ventilated patients Therefore the purpose of this study is to compare the effects of RCC and the PEEP-ZEEP maneuver on oxygenation ventilation and airway-secretion removal in mechanically ventilated patients By evaluating these outcomes we can gain insights into the potential benefits and limitations of each technique ultimately contributing to the optimization of respiratory support strategies in critically ill patients
The findings of this study can have important implications for CCN clinical practice as they can inform CCNs about the efficacy and safety of RCC and the PEEP-ZEEP maneuver Improving oxygenation ventilation and airway-secretion removal in mechanically ventilated patients can lead to enhanced patient outcomes reduced complications and potentially shorter durations of mechanical ventilation and intensive care unit stays
This technique increases forced expiratory volume by 30 and leads to the resting of the expiratory muscles Most of all the technique is quite safe as it has been employed in some patients for more than 3 years with no complications Therefore this technique can be used before the patients endotracheal suctioning interventions and it is widely used with mechanically ventilated patients to prevent andor to treat atelectasis In addition removing secretion is essential because accumulated secretions intervene in gas exchange and may delay recovery coughing can be initiated voluntarily or by reflex
The positive end-expiratory pressure-zero end-expiratory pressure maneuver considers that by raising PEEP to 15 cmH2O during five cycles followed by an abrupt reduction of PEEP to 0 cmH2O gas redistribution occurs through collateral ventilation Subsequently small airways are opened and the adhered mucus is displaced With the reduction of PEEP the expiratory flow pattern is modified causing the secretions located in smaller airways to be transported to the central airways
While many studies have looked at the effects of rib cage compression RCC or the PEEP-ZEEP maneuver individually there is a need for comparative studies that directly compare these two techniques Understanding the different effects of these interventions on oxygenation ventilation and airway-secretion removal can help critical care nurses CCNs choose the most effective strategy for mechanically ventilated patients Therefore the purpose of this study is to compare the effects of RCC and the PEEP-ZEEP maneuver on oxygenation ventilation and airway-secretion removal in mechanically ventilated patients By evaluating these outcomes we can gain insights into the potential benefits and limitations of each technique ultimately contributing to the optimization of respiratory support strategies in critically ill patients
The findings of this study can have important implications for CCN clinical practice as they can inform CCNs about the efficacy and safety of RCC and the PEEP-ZEEP maneuver Improving oxygenation ventilation and airway-secretion removal in mechanically ventilated patients can lead to enhanced patient outcomes reduced complications and potentially shorter durations of mechanical ventilation and intensive care unit stays
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None