The effect of manual precision and mechanical vibration on pulmonary parameters of patients undergoing mechanical ventilation in intensive care units
Design
A randomized crossover clinical trial
Settings and conduct
For each patient, there are 90 minutes intervals between manual precussion and mechanical vibration which is done by researcher.
To perform a manual precision, the wrist strikes the right wrist, which is cup-shaped and equal in strength from the height of ten centimeters to the back and front of the patient's chest. The chest is divided into four segments, percussion done for each with a thirty-second . These beats are performed at speeds of 4 times per second for 4 minutes at the time of Inhale and exhale
To vibrate , a constant frequency of 2 Hz is used, and is performed by the researcher for 1 to one and a half minutes during the patient's breathing during exhalation. The shaking is done by placing the vibrating device on the back and front of the chest. In this intervention, the chest is divided into four upper and lower right and left sections, each of which is vibrated by five vibrations during exhalation.
Participants/Inclusion and exclusion criteria
Age over 18 years
Being connected to a mechanical ventilator
Complete cardiopulmonary monitoring
Hemodynamic stability in the last 6 hours according to anesthesiologist
Absence of spinal cord injuries
No lung disease and no pneumothorax, hemothorax and rib fracture
Recurrent volume of gastric discharge less than 100 ml before intervention
Intervention groups
Group A is the group which first receive manual percussion and after the wash out period mechanical vibration is performed on them
Group B is the group that is first mechanical vibration performed after the washout period
recieve manual percussion.
Survey effect of manual percussion and mechanical vibration on respiratory indexes in mechanically ventilated patients
Public title
Survey effect of manual percussion and mechanical vibration on respiratory indexes in mechanically ventilated patients in Rasht Poursina hospital critical care units 2019- 2020
Purpose
Prevention
Inclusion/Exclusion criteria
Inclusion criteria:
Age over 18 years
Connected to mechanical ventilation
Complete cardiopulmonary monitoring
Hemodynamic stability in the last 6 hours according to anesthesiologist
Absence of spinal cord injuries
No pulmonary disease and no pneumothorax, hemothorax and rib fracture
Recurrent volume of gastric lavage less than 100 ml before intervention
Exclusion criteria:
Hemodynamic parameters instability
Increased intracranial pressure
The need for emergency suctioning during the intervention
Changes in ventilator device settings and modes during the study
Patient leaving the ward to perform paraclinical procedures and withdraw from monitoring
Age
From 18 years old
Gender
Both
Phase
N/A
Groups that have been masked
Participant
Sample size
Target sample size:
62
Randomization (investigator's opinion)
Randomized
Randomization description
Specimens are assigned randomly to quadruple blocks in order to select the sequence of intervention in groups A and B, which will be sequenced using" Random block " software. The proprietary Randomized Allocation is kept in a sealed package with the ward supervisor. And before starting the intervention will open. Based on the daily and inpatient referrals in the section according to the sequence of samples will be divided into groups A and B. Group A is the group which first receive manual percussion and after the wash out period mechanical vibration is performed on them and Group B is the group that is first mechanical vibration performed after the washout period
recieve manual percussion.
Blinding (investigator's opinion)
Single blinded
Blinding description
participant. They do not know the order of the interventions
Placebo
Not used
Assignment
Crossover
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Guilan University of Medical Sciences
Street address
Student of Nursing and Midwifery Faculty, Shahid Beheshti Highway, Rasht
City
Rasht
Province
Guilan
Postal code
4146939841
Approval date
2020-01-18, 1398/10/28
Ethics committee reference number
IR.GUMS.REC.1398.468
Health conditions studied
1
Description of health condition studied
Chest physiotherapy
ICD-10 code
ICD-10 code description
Primary outcomes
1
Description
Pulmonary compliance
Timepoint
Before intervention and 1, 5, 15, 30 minutes after intervention in each group
Method of measurement
View on ventilator screen
2
Description
Airway resistance
Timepoint
Before intervention and 1, 5, 15, 30 minutes after intervention in each group
Method of measurement
View on ventilator screen
3
Description
Percentage of arterial blood oxygen saturation
Timepoint
Before intervention and 1, 5, 15, 30 minutes after intervention in each group
Method of measurement
From the monitoring screen connected to the patient
Secondary outcomes
empty
Intervention groups
1
Description
First Intervention group: or group A: the group that first received manual percussion and after wash out period mechnical vibration perform on them .one hour after suction and before the intervention started ,the indices like pulmonary compliance and airway resistance seen on the ventilator screen is recorded as well as the percentage of arterial oxygen saturation from the monitor next to the patient's bed. Indicators are recorded immediately after each intervention, and at 1, 5, 15 and 30 minutes after each intervention.
Category
Prevention
2
Description
Intervention group: the group that first received mechanical vibration and after wash out period manual percussion perform on them .one hour after suction and before intervention started ,the indices like pulmonary compliance and airway resistance seen on the ventilator screen is recorded as well as the percentage of arterial oxygen saturation from the monitor next to the patient's bed. Indicators are recorded immediately after each intervention, and at 1, 5, 15 and 30 minutes after each intervention.