Bonczynski GS, Novo JS, Dias AS, Martins LDFG, Naue WDS, Volpe MS, Junior LAF. Ventilator hyperinflation associated with flow bias optimization in the bronchial hygiene of mechanically ventilated patients.
Heart Lung 2024;
64:31-35. [PMID:
37988854 DOI:
10.1016/j.hrtlng.2023.10.011]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND
Ventilation configurations are of great clinical importance for adequate outcomes in mechanically ventilated patients, and they may even be used as specific physical therapy techniques.
OBJECTIVES
To compare the effectiveness of lung hyperinflation through mechanical ventilation (HMV) with HMV plus flow bias optimization regarding respiratory mechanics, hemodynamics, and volume of secretion.
METHODS
Patients mechanically ventilated > 24 h were included in this randomized crossover clinical trial. The following techniques were applied: HMV alone (control group) and HMV plus flow bias optimization (intervention group).
RESULTS
The 20 included patients underwent both techniques, totaling 40 collections. A total of 52 % were women, the mean age was 60.8 (SD, 15.7) years, and the mean mechanical ventilation time was 4.3 (SD, 3.0) days. The main cause of mechanical ventilation was sepsis (44 %). Expiratory flow bias in optimized HMV was higher. than conventional HMV (p < 0.001). The volume of tracheal secretions collected was higher during optimized than conventional HMV. (p = 0.012). Significant differences in peak flow occurred at the beginning of the technique and a there was a significant decrease in respiratory system resistance immediately and 30 min after applying the technique in the intervention group.
CONCLUSIONS
The volume of tracheal secretions collected was higher during optimized HMV, and, HMV with flow bias optimization resulted in lower respiratory system resistance and flow peaks and produced expiratory flow bias.
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