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Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial
OBJECTIVE: To evaluate the effects of ventilator hyperinflation on respiratory mechanics. METHODS: A randomized crossover clinical trial was conducted with 38 mechanically ventilated patients with pulmonary infection. The order of the hyperinflation and control (without changes in the parameters) co...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Associação de Medicina Intensiva Brasileira - AMIB
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005952/ https://www.ncbi.nlm.nih.gov/pubmed/31618346 http://dx.doi.org/10.5935/0103-507X.20190052 |
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author | Chicayban, Luciano Matos |
author_facet | Chicayban, Luciano Matos |
author_sort | Chicayban, Luciano Matos |
collection | PubMed |
description | OBJECTIVE: To evaluate the effects of ventilator hyperinflation on respiratory mechanics. METHODS: A randomized crossover clinical trial was conducted with 38 mechanically ventilated patients with pulmonary infection. The order of the hyperinflation and control (without changes in the parameters) conditions was randomized. Hyperinflation was performed for 5 minutes in pressure-controlled ventilation mode, with progressive increases of 5cmH(2)O until a maximum pressure of 35cmH(2)O was reached, maintaining positive end expiratory pressure. After 35cmH(2)O was reached, the inspiratory time and respiratory rate were adjusted so that the inspiratory and expiratory flows reached baseline levels. Measurements of static compliance, total resistance and airway resistance, and peak expiratory flow were evaluated before the technique, immediately after the technique and after aspiration. Two-way analysis of variance for repeated measures was used with Tukey's post hoc test, and p < 0.05 was considered significant. RESULTS: Ventilator hyperinflation increased static compliance, which remained at the same level after aspiration (46.2 ± 14.8 versus 52.0 ± 14.9 versus 52.3 ± 16.0mL/cmH(2)O; p < 0.001). There was a transient increase in airway resistance (6.6 ± 3.6 versus 8.0 ± 5.5 versus 6.6 ± 3.5cmH(2)O/Ls(-1); p < 0.001) and a transient reduction in peak expiratory flow (32.0 ± 16.0 versus 29.8 ± 14.8 versus 32.1 ± 15.3Lpm; p <0.05) immediately after the technique; these values returned to pretechnique levels after tracheal aspiration. There were no changes in the control condition, nor were hemodynamic alterations observed. CONCLUSION: Ventilator hyperinflation promoted increased compliance associated with a transient increase in airway resistance and peak expiratory flow, with reduction after aspiration. |
format | Online Article Text |
id | pubmed-7005952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Associação de Medicina Intensiva Brasileira - AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-70059522020-02-11 Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial Chicayban, Luciano Matos Rev Bras Ter Intensiva Original Articles OBJECTIVE: To evaluate the effects of ventilator hyperinflation on respiratory mechanics. METHODS: A randomized crossover clinical trial was conducted with 38 mechanically ventilated patients with pulmonary infection. The order of the hyperinflation and control (without changes in the parameters) conditions was randomized. Hyperinflation was performed for 5 minutes in pressure-controlled ventilation mode, with progressive increases of 5cmH(2)O until a maximum pressure of 35cmH(2)O was reached, maintaining positive end expiratory pressure. After 35cmH(2)O was reached, the inspiratory time and respiratory rate were adjusted so that the inspiratory and expiratory flows reached baseline levels. Measurements of static compliance, total resistance and airway resistance, and peak expiratory flow were evaluated before the technique, immediately after the technique and after aspiration. Two-way analysis of variance for repeated measures was used with Tukey's post hoc test, and p < 0.05 was considered significant. RESULTS: Ventilator hyperinflation increased static compliance, which remained at the same level after aspiration (46.2 ± 14.8 versus 52.0 ± 14.9 versus 52.3 ± 16.0mL/cmH(2)O; p < 0.001). There was a transient increase in airway resistance (6.6 ± 3.6 versus 8.0 ± 5.5 versus 6.6 ± 3.5cmH(2)O/Ls(-1); p < 0.001) and a transient reduction in peak expiratory flow (32.0 ± 16.0 versus 29.8 ± 14.8 versus 32.1 ± 15.3Lpm; p <0.05) immediately after the technique; these values returned to pretechnique levels after tracheal aspiration. There were no changes in the control condition, nor were hemodynamic alterations observed. CONCLUSION: Ventilator hyperinflation promoted increased compliance associated with a transient increase in airway resistance and peak expiratory flow, with reduction after aspiration. Associação de Medicina Intensiva Brasileira - AMIB 2019 /pmc/articles/PMC7005952/ /pubmed/31618346 http://dx.doi.org/10.5935/0103-507X.20190052 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Chicayban, Luciano Matos Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title | Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title_full | Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title_fullStr | Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title_full_unstemmed | Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title_short | Acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
title_sort | acute effects of ventilator hyperinflation with increased inspiratory time on respiratory mechanics: randomized crossover clinical trial |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005952/ https://www.ncbi.nlm.nih.gov/pubmed/31618346 http://dx.doi.org/10.5935/0103-507X.20190052 |
work_keys_str_mv | AT chicaybanlucianomatos acuteeffectsofventilatorhyperinflationwithincreasedinspiratorytimeonrespiratorymechanicsrandomizedcrossoverclinicaltrial |