Lung Recruitment During Chest Physiotherapy in Mechanically Ventilated Patients

Launched by ASSISTANCE PUBLIQUE - HÔPITAUX DE PARIS · Jan 30, 2025

Keywords

ClinConnect Summary

This clinical trial is studying the effects of different breathing support methods on patients in intensive care who are on a ventilator and need help clearing mucus from their lungs. The goal is to see how well a technique called chest physiotherapy works in helping these patients breathe better and recover faster. This study will look specifically at two common types of ventilator settings: Volume Assist Control Ventilation (V-ACV) and Pressure Support Ventilation (PSV), to find out if one is better than the other for patients who have a lot of mucus in their airways.

To participate in the trial, patients must be between the ages of 65 and 100 and currently receiving assisted ventilation, needing frequent mucus suctioning. They also need to give consent, and their treatment must be covered by social security. Patients who have had recent surgeries, certain medical conditions, or are pregnant cannot join. If they take part, patients can expect to receive daily chest physiotherapy while being monitored closely to check how well they are responding to the treatment. This research aims to improve care for patients on ventilators, making it easier for them to breathe and recover.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient under assisted ventilation (in V-ACV or PSV) triggering all ventilator cycles
• • Patient deemed " secretive ": requiring ≥ 2 tracheal aspirations every 3 hours
• • Patient (or relative) who has given consent to participate in the research
• • Patient covered by social security
• Exclusion Criteria:
• • Age under 18 years
• • Legal guardian required
• • Recent cardiac and/or thoracic and/or abdominal surgery (\< 3 months)
• • Rib fracture(s)
• • Pneumothorax and/or presence of a chest drain
• • Recent neurosurgery (\< 3 months) and/or proven or suspected increased intracranial pressure (ICP)
• • Hemodynamic instability defined as: noradrenaline ≥ 1mg/h, adrenaline ≥ 0.5 mg/h, dobutamine ≥ 5γ/kg/min.
• • Respiratory instability defined as: PEEP \> 10 cmH2O and/or PaO2/FiO2 \< 150 mm Hg
• • Pregnancy
• • Hemoptysis
• • Sever skin lesions (e.g., burns, Lyell's syndrome)
• • Patient under foreign health insurance