Ignite Creation Date:
2024-05-06 @ 8:20 PM
Last Modification Date:
2024-10-26 @ 3:25 PM
Study NCT ID:
NCT06341244
Status:
COMPLETED
Last Update Posted:
2024-04-02
First Post:
2024-03-19
Brief Title:
Air Stacking Technique Efficacy on Peak of Expiratory Flow and Cough Peak Flow in Non-cardiac Thoracic Surgery
Sponsor:
Universidade Cidade de Sao Paulo
Organization:
Universidade Cidade de Sao Paulo
Study Overview
Official Title:
Air Stacking Technique Efficacy on Expiratory Peak of Expiratory Flow and Cough Peak Flow in Patients Undergoing Non-cardiac Thoracic Surgery
Status:
COMPLETED
Status Verified Date:
2024-03
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:
After thoracic surgical intervention patients often feel intense pain with respiratory movements reduction making coughing less effective The air stacking improves peak of expiratory flow PEF and cough peak flow CPF in neuro myopathies thus raising the hypothesis that may also be effective in patients undergoing thoracic surgeries Objectives To evaluate the effectiveness safety and feasibility of air stacking on postoperative PEF and CPF in patients undergoing thoracic surgeries Methods Patients undergoing thoracic surgery underwent air stacking on 3th PO Dyspnea pain SpO2 maximum inspirational pressure MIP maximum expiratory pressure MEP PEF and CPF were evaluated in pre and postoperatory
Detailed Description:
Surgical intervention is a treatment option for many diseases of the thorax After thoracotomy ventilatory patterns change lung volumes and pulmonary capacities decrease due to the reflex inhibition of the diaphragm muscle and the sigh mechanism becomes impaired even if the procedure does not include pulmonary resection These changes often lead to postoperative pulmonary complications which may increase length of stay in the hospital The role of physical therapy in minimizing these risks is critical and several techniques are available to improve both lung volume and capacity and to make coughing more effective The air stacking technique allows enough air to be accumulated in the lungs to generate an acceptable cough peak flow CPF Several studies have shown that the use of this technique in patients with neuromuscular disease positively impacts the biomechanical components of peak expiratory flow PEF and CPF This study aimed to evaluate the effectiveness safety and feasibility of the air stacking technique application and its effect on PEF and CPF during the postoperative period in patients undergoing elective noncardiac intrathoracic surgery We conducted an interventional experimental study involving hospitalized patients for thoracic surgery in a teaching hospital The study was approved by the Ethics Committee in Human Research 4269301500005505 and the patients freely signed an informed consent form prior to participation Maximal inspiratory and expiratory pressure MIP and MEP were measured with a previously calibrated aneroid manometer GER-AR ranging from 5 to 300 cmH2O A mouthpiece was attached to the manovacuometer and the nasal clip was used during the maneuvers following previous recommendations 12 For maximal inspiratory and expiratory pressures assessment maximum effort was requested from the residual volume and total lung capacity respectively Results were compared to predicted values according to the equation proposed by Neder et al PEF and CPF were measured with a peak flow meter ranging from 100 to 900 Lmin following the literature recommendations The patient remained seated at 90ยบ with a nasal clip and was asked to force maximum expiration as fast as he could through the mouthpiece after maximum inspiration to measure PEF To measure cough peak flow the patient repeated the inspiratory maneuver and was asked to cough as hard as he could At least three measurements of both variables were performed provided that the last measurement was not higher than others The highest obtained value was considered as the result To perform the air stacking technique an air manual breathing unit AMBU was used attached to a unidirectional valve and nasaloral mask The technique was performed with the patient in a sitting position head resting on a smooth surface to avoid neck hyperextension The mask was fit to the patients face and the AMBU one-way valve was kept closed For each AMBU manual compression three in the total the patient was instructed to breathe in deeply and hold the air inside the lungs Immediately after the first manual compression the second and third were performed while the patient is deep breathing in together without exhaling the air PEF was measured immediately after the technique The patient rested for 5 minutes and the air staking technique was repeated The same procedure was performed to measure CPF followed by a clinical evaluation including vital signs visual lung expansion and auscultation dyspnea and pain evaluation Sample size calculation was based on previous study performed by Brito et al A minimum difference of 4 and a maximum difference of 47 were found between PEF and CPF means before and after air stacking technique Considering a power of 90 and an alpha error of 5 a power analysis revealed that a minimum number of 17 patients should be included in the study
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