Effects of Mechanical Insufflation-Exsufflation With Optimized Settings on Wet Mucus Volume During Invasive Ventilation

Launched by HOSPITAL CLINIC OF BARCELONA · Jul 5, 2024

Keywords

ClinConnect Summary

This clinical trial is investigating a technique called Mechanical Insufflation-Exsufflation (MI-E) to help clear mucus from the airways of critically ill patients who are on invasive mechanical ventilation. In simpler terms, the study aims to find out if using a specially designed machine with optimized settings can help remove more mucus compared to standard settings. This is important because many patients on ventilators struggle with excessive mucus, which can make it harder for them to breathe.

To participate in this trial, individuals must be adults over 18 years old who have been intubated and receiving mechanical ventilation for more than 48 hours. They should also have been receiving humidification for at least 24 hours and have a certain level of sedation. However, some patients will not be eligible, such as those with unstable heart or respiratory conditions, recent heart surgery, or pregnancy. Participants can expect to have their mucus levels measured and compared between the two different MI-E settings during their time in the study. This research could lead to improved care for patients with difficult mucus clearance in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adults (\> 18yo).
• • Endotracheal intubation and invasive mechanical ventilation for \> 48h and active humidification for \> 24h.
• • Richmond Agitation-Sedation Scale -3 to -5.
• • Signed informed consent.
• Exclusion Criteria:
• • Patients with hemodynamic instability (MAP \< 60 or \> 110, Heart Rate \< 50 or \> 130, new onset arrhythmias), respiratory instability (PEEP \> 12cmH2O, SpO2 \< 90% or fraction of inspired oxygen (FiO2) \> 60%).
• • Undrained pneumothorax/pneumomediastinum.
• • Unstable intracranial pressure (ICP \> 20mmHg or MAP \< 60).
• • Severe bronchospasm.
• • Post cardiothoracic surgical patients.
• • Active pulmonary tuberculosis.
• • Bronchoesophageal or bronchopleural fistulas.
• • Prone position.
• • Pregnancy.