To Assess the Effectiveness of Three Distinct Mechanical Assisted Sputum Evacuation Apparatuses in the Treatment of Patients With Mechanical Ventilation-induced Atelectasis

Launched by SIR RUN RUN SHAW HOSPITAL · Oct 6, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how effective three different devices are at helping patients on mechanical ventilation to clear mucus from their airways. When patients are on mechanical ventilation, they may have trouble getting rid of mucus, which can lead to a condition called atelectasis, where parts of the lung collapse and don’t get enough air. The devices being tested include the MetaNeb® System, High Frequency Chest Wall Oscillation (HFCWO), and Cycloid Vibration Therapy (CVT). The goal is to find out which device works best in helping patients breathe better and maintain good oxygen levels.

To be eligible for this trial, participants must be at least 18 years old and have been diagnosed with airway blockage due to mucus while on mechanical ventilation for at least 48 hours. They should also have evidence of atelectasis confirmed by medical imaging tests. Patients with certain serious health conditions or those who are pregnant will not be included. If someone joins the trial, they can expect to use one of the three devices and help researchers learn how to improve care for patients needing mechanical ventilation. This is an important step toward finding better ways to manage airway health in critically ill patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • ≥18 years old.
• • patients who were diagnosed as obstructed airway secretion clearance and required mechanical sputum evacuation in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Among them, patients using CVT were included in the CVT cohort, patients using Metaneb were included in the Metaneb cohort, and patients using high-frequency chest wall oscillation (HFCWO) were included in the high-frequency chest wall oscillation (HFCWO) cohort.
• • voluntarily participated in this study and signed the informed consent. If the subjects were unable to read and sign the informed consent form due to incapacity or other reasons, their guardians were required to act for them during the informed consent process and sign the informed consent form. If the subjects were unable to read the informed consent form (e.g., illiterate subjects), witnesses were required to witness the informed consent process and sign the informed consent.
• • Invasive mechanical ventilation ≥48 hours.
• • Atelectasis was confirmed by chest CT, chest X-ray or lung ultrasound.
• Exclusion Criteria:
• • BMI≥40kg/m2.
• • Severe spinal and thoracic deformity.
• • Known or suspected diaphragmatic dysfunction such as phrenic nerve rupture, neuromuscular disease, etc.
• • untreated tension pneumothorax.
• • Active bleeding in the lung.
• • Severe hemodynamic instability (increased dose of vasoactive drugs within 2 hours or MAP≤65mmHg).
• • Severe other organ dysfunction was expected to result in short-term death (7 days) or palliative treatment.
• • Other reasons considered by the medical team not suitable for treatment.
• • Pregnancy status.