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IRCT20191030045281N1 IRCT 2020-06-25 Sanandaj University of Medical Sciences Comparison the effect of applying “expiratory rib cage compression” and “manual percussion” before suction on respiratory parameters Comparison the effect of applying “expiratory rib cage compression” and “manual percussion” before suction on respiratory parameters in patients under mechanical ventilation 2020-05-21 anticipated 46 Complete https://irct.ir/trial/43562 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Crossover, Purpose: Prevention, Randomization description: Group A is a group that will be carried out first by manual percussion and then expiratory rib cage compression. Group B group that will be performed first by expiratory rib cage compression and then manual percussion . The letter A is written on 23 cards and the letter B on the other 23 cards. One of these two cards is randomly selected for each patient. Patients with card A enter Group A and patients with card B enter Group B. N/A Patients under mechanical ventilation. Intervention 1: Group A is the group that will do the manual percussion first and then expiratory rib cage compression. In the manual percussion procedure, the hands are cupped and all fingers are folded and the wrist joint is opened and performed at speeds of 100 to 120 times per minute. In the expiratory rib cage compression,gradually compressed the end and lateral parts of patients’ rib cage during expiration by his hands. This technique was bilaterally performed, and in the end of expiration, the compression was released from the patients’ rib cage to let them have a free inspiration. Both interventions will be performed by the researcher in one day with a 3-hour interval (to neutralize the previous intervention), respectively. Respiratory parameters: increased end-expiratory CO2, pulmonary compliance and hemoglobin saturation, and respiratory rate and airway resistance in patients undergoing mechanical ventilation in the ICU will be assessed before and 1, 5 and 25 minutes after endotracheal suctioning. Intervention 2: Group B is the group that first will do the expiratory rib cage compression and then manual percussion before the suction. In the manual percussion procedure, the hands are cupped and all fingers are folded and the wrist joint is opened and performed at speeds of 100 to 120 times per minute. In the expiratory rib cage compression,gradually compressed the end and lateral parts of patients’ rib cage during expiration by his hands. This technique was bilaterally performed, and in the end of expiration, the compression was released from the patients’ rib cage to let them have a free inspiration. Both interventions will be performed by the researcher in one day with a 3-hour interval (to neutralize the previous intervention), respectively. Respiratory parameters: increased end-expiratory CO2, pulmonary compliance and hemoglobin saturation, and respiratory rate and airway resistance in patients undergoing mechanical ventilation in the ICU will be assessed before and 1, 5 and 25 minutes after endotracheal suctioning. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is No more information
public Maryam Rasuli
Narges 5 Suleiman Bag Street 37
Baneh Iran (Islamic Republic of) 66918-64496 +98 87 3424 0418 maryam.rasuli@muk.ac.ir Sanandaj University of Medical Sciences scientific Dr. Mohammad Fathi
Kurdistan University of Medical Sciences Campus, Pasdaran Ave, Sanandaj
Sanandaj Iran (Islamic Republic of) 66177-13446 +98 87 3366 4653 fathi_sanan@yahoo.com Sanandaj University of Medical Sciences Iran (Islamic Republic of) intubated patients Patients under mechanical ventilation with volumetric mode For at least 48 hours under mechanical ventilation not needing more than 2 times suction per shift patients with stable hemodynamic parameters reversible gastric secretion less than 100 ml before Intervention Age between 18 and 65 years 18 years 65 years Both Respiratory distress pneumothorax and Fractures of the ribs, sternum and chest chest burns and surgery dysrhythmia and heart disease Abscess and lung cyst Prevention Prevention Group A is the group that will do the manual percussion first and then expiratory rib cage compression. In the manual percussion procedure, the hands are cupped and all fingers are folded and the wrist joint is opened and performed at speeds of 100 to 120 times per minute. In the expiratory rib cage compression,gradually compressed the end and lateral parts of patients’ rib cage during expiration by his hands. This technique was bilaterally performed, and in the end of expiration, the compression was released from the patients’ rib cage to let them have a free inspiration. Both interventions will be performed by the researcher in one day with a 3-hour interval (to neutralize the previous intervention), respectively. Respiratory parameters: increased end-expiratory CO2, pulmonary compliance and hemoglobin saturation, and respiratory rate and airway resistance in patients undergoing mechanical ventilation in the ICU will be assessed before and 1, 5 and 25 minutes after endotracheal suctioning. Group B is the group that first will do the expiratory rib cage compression and then manual percussion before the suction. In the manual percussion procedure, the hands are cupped and all fingers are folded and the wrist joint is opened and performed at speeds of 100 to 120 times per minute. In the expiratory rib cage compression,gradually compressed the end and lateral parts of patients’ rib cage during expiration by his hands. This technique was bilaterally performed, and in the end of expiration, the compression was released from the patients’ rib cage to let them have a free inspiration. Both interventions will be performed by the researcher in one day with a 3-hour interval (to neutralize the previous intervention), respectively. Respiratory parameters: increased end-expiratory CO2, pulmonary compliance and hemoglobin saturation, and respiratory rate and airway resistance in patients undergoing mechanical ventilation in the ICU will be assessed before and 1, 5 and 25 minutes after endotracheal suctioning. End Tidal CO2. Timepoint: Exhaled CO2 is measured 4 times: before and minutes 1, 5 and 25 minutes after endotracheal suctioning. Method of measurement: Using Capnography Probe. Oxygen saturation (SPO2). Timepoint: Oxygen saturation (SPO2) is measured 4 times: before and minutes 1, 5 and 25 minutes after endotracheal suction. Method of measurement: Using a pulse oximeter device (via monitor view). Pulmonary compliance. Timepoint: Pulmonary compliance is measured 4 times: before and minutes 1, 5 and 25 minutes after endotracheal suction. Method of measurement: Through viewing the ventilator screen. Airway resistance. Timepoint: Airway resistance measured 4 times: before and minutes 1, 5 and 25 minutes after endotracheal suction. Method of measurement: Through viewing the ventilator screen. Respiratory rate. Timepoint: Respiratory rate is measured 4 times: before and minutes 1, 5 and 25 minutes after endotracheal suction. Method of measurement: Total spontaneous breathing and ventilator-provided breathing per minute by viewing the ventilator screen. Sanandaj University of Medical Sciences Approved 2020-03-14 Ethics committee of Kurdistan University of Medical Sciences Kurdistan University of Medical Sciences Campus, Pasdaran Ave, Sanandaj Sanandaj Kurdistan Iran (Islamic Republic of)