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Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study
Clearance of secretions remains a challenge in ventilated patients. Despite high-frequency percussive ventilation (HFPV) showing benefits in patients with cystic fibrosis and neuromuscular disorders, very little is known about its effects on other patient categories. Therefore, we designed a physiol...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175357/ https://www.ncbi.nlm.nih.gov/pubmed/36607533 http://dx.doi.org/10.1007/s10877-022-00970-7 |
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author | Garofalo, Eugenio Rovida, Serena Cammarota, Gianmaria Biamonte, Eugenio Troisi, Letizia Cosenza, Leonardo Pelaia, Corrado Navalesi, Paolo Longhini, Federico Bruni, Andrea |
author_facet | Garofalo, Eugenio Rovida, Serena Cammarota, Gianmaria Biamonte, Eugenio Troisi, Letizia Cosenza, Leonardo Pelaia, Corrado Navalesi, Paolo Longhini, Federico Bruni, Andrea |
author_sort | Garofalo, Eugenio |
collection | PubMed |
description | Clearance of secretions remains a challenge in ventilated patients. Despite high-frequency percussive ventilation (HFPV) showing benefits in patients with cystic fibrosis and neuromuscular disorders, very little is known about its effects on other patient categories. Therefore, we designed a physiological pilot study investigating the effects on lung aeration and gas exchange of short HFPV cycles in tracheostomized patients undergoing mechanical ventilation. Electrical impedance tomography (EIT) was recorded at baseline (T0) by a belt wrapped around the patient's chest, followed by the HFPV cycle lasting 10 min. EIT data was collected again after the HFPV cycle (T1) as well as after 1 h (T2) and 3 h (T3) from T0. Variation from baseline of end-expiratory lung impedance (∆EELI), tidal variation (TIV) and global inhomogeneity index (GI) were computed. Arterial blood was also taken for gas analysis. HFPV cycle significantly improved the ∆EELI at T1, T2 and T3 when compared to baseline (p < 0.05 for all comparisons). The ratio between arterial partial pressure and inspired fraction of oxygen (PaO(2)/FiO(2)) also increased after the treatment (p < 0.001 for all comparison) whereas TIV (p = 0.132) and GI (p = 0.114) remained unchanged. Short cycles of HFPV superimposed to mechanical ventilation promoted alveolar recruitment, as suggested by improved ∆EELI, and improved oxygenation in tracheostomized patients with high load of secretion. Trial Registration Prospectively registered on www.clinicaltrials.gov (NCT05200507; dated 6th January 2022). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-022-00970-7. |
format | Online Article Text |
id | pubmed-10175357 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-101753572023-05-13 Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study Garofalo, Eugenio Rovida, Serena Cammarota, Gianmaria Biamonte, Eugenio Troisi, Letizia Cosenza, Leonardo Pelaia, Corrado Navalesi, Paolo Longhini, Federico Bruni, Andrea J Clin Monit Comput Original Research Clearance of secretions remains a challenge in ventilated patients. Despite high-frequency percussive ventilation (HFPV) showing benefits in patients with cystic fibrosis and neuromuscular disorders, very little is known about its effects on other patient categories. Therefore, we designed a physiological pilot study investigating the effects on lung aeration and gas exchange of short HFPV cycles in tracheostomized patients undergoing mechanical ventilation. Electrical impedance tomography (EIT) was recorded at baseline (T0) by a belt wrapped around the patient's chest, followed by the HFPV cycle lasting 10 min. EIT data was collected again after the HFPV cycle (T1) as well as after 1 h (T2) and 3 h (T3) from T0. Variation from baseline of end-expiratory lung impedance (∆EELI), tidal variation (TIV) and global inhomogeneity index (GI) were computed. Arterial blood was also taken for gas analysis. HFPV cycle significantly improved the ∆EELI at T1, T2 and T3 when compared to baseline (p < 0.05 for all comparisons). The ratio between arterial partial pressure and inspired fraction of oxygen (PaO(2)/FiO(2)) also increased after the treatment (p < 0.001 for all comparison) whereas TIV (p = 0.132) and GI (p = 0.114) remained unchanged. Short cycles of HFPV superimposed to mechanical ventilation promoted alveolar recruitment, as suggested by improved ∆EELI, and improved oxygenation in tracheostomized patients with high load of secretion. Trial Registration Prospectively registered on www.clinicaltrials.gov (NCT05200507; dated 6th January 2022). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-022-00970-7. Springer Netherlands 2023-01-06 2023 /pmc/articles/PMC10175357/ /pubmed/36607533 http://dx.doi.org/10.1007/s10877-022-00970-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Research Garofalo, Eugenio Rovida, Serena Cammarota, Gianmaria Biamonte, Eugenio Troisi, Letizia Cosenza, Leonardo Pelaia, Corrado Navalesi, Paolo Longhini, Federico Bruni, Andrea Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title | Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title_full | Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title_fullStr | Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title_full_unstemmed | Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title_short | Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
title_sort | benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175357/ https://www.ncbi.nlm.nih.gov/pubmed/36607533 http://dx.doi.org/10.1007/s10877-022-00970-7 |
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