To compare a *routine* MH strategy with an *on demand* MH strategy in cardiothoracic surgery patients with respect to post*extubation SpO2 and FRC.
ID
Source
Brief title
Condition
- Respiratory tract infections
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
peripheral hemoglobin oxygen saturation (SPO2)
Functional Residual Capacity (FRC)
Secondary outcome
The number of MH maneuvers per patient (routinely performed as well as those on
indication in the *routine* strategy group versus *on demand* in the *on
demand* strategy group)
Duration of tracheal intubation
Length of stay in the intensive care unit
Background summary
Manual hyperinflation (MH) is a frequently performed maneuver as part of airway
management in intubated and mechanically ventilated patients. MH involves
disconnecting the patient from the mechanical ventilator and inflating the
lungs via a manual resuscitation bag.
In case of noted sputum in the airways or when peripheral hemoglobin oxygen
saturation (SpO2) falls, MH is often a first step to improve mechanical
ventilation and oxygenation (so*called *on demand* MH). Some experts advocate
performing MH more frequently, on a routine basis (so*called *routine* MH,
e.g., every 6 hours).
Although mobilization of airway secretions, prevention of sputum plugging and
improved alveolar recruitment are cited as potential benefits of MH there is no
solid evidence supporting this, above all not for *routine* MH. Of note, MH
could be associated with adverse events and also could cause agitation of the
patient .
Functional residual capacity (FRC) after cardiothoracic surgery is reduced
significantly. Since MH could improve alveolar recruitment and as result the
FRC, *routine* MH may benefit these patients.
Study objective
To compare a *routine* MH strategy with an *on demand* MH strategy in
cardiothoracic surgery patients with respect to post*extubation SpO2 and FRC.
Study design
Randomized clinical trial
Two MH strategies are compared: For the first strategy in 50 patients MH is
performed routinely for the second strategy in 50 patients the MH procedure is
performed only on indication.
Intervention
not applicabel
Study burden and risks
MH is part of the daily care of mechanical ventilated patients. For this study
at four different times FRC is measured.
FRC-measurement is a non-invasive procedure; it will take about 10 minutes of
the patient*s time and is well tolerated.
At the same moment SPO2 is measured with pulse oximetry, which is also a
non-invasive procedure which is not burdensome to the patient. No additional
bloodsamples are taken.
meibergdreef 9
1105 AZ Amsterdam
Nederland
meibergdreef 9
1105 AZ Amsterdam
Nederland
Listed location countries
Age
Inclusion criteria
Patients planned for coronary artery bypass grafting and/or valve surgery are recruited
> 18 years of age
written informed consent
Exclusion criteria
(Previous) pulmonary surgery
Pulmonary infection
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| Other | kandidaat registratie NTR 3640 |
| CCMO | NL24317.018.08 |