| Titre : | Effect of inspiratory rise time on sputum movement during ventilator hyperinflation in a test lung model (2019) |
| Auteurs : | R.L. Chapman ; H. Shannon ; E. Koutoumanou |
| Type de document : | Article |
| Dans : | Physiotherapy (Vol. 105, n° 2, 2019) |
| Article en page(s) : | p. 283-289 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Débit expiratoire de pointe ; Expectoration ; Kinésithérapeutes ; Respirateurs artificiels ; Volume courant |
| Résumé : |
Objectives
Physiotherapists may use ventilator hyperinflation to enhance secretion clearance for intubated patients. This study investigated the effects of altering percentage inspiratory rise time (IRT) on sputum movement, ratio of peak inspiratory to expiratory flow rate (PIF:PEF ratio) and net peak expiratory flow (PEF) during ventilator hyperinflation in a test lung model. Design Laboratory-based bench study. Interventions Simulated sputum (two viscosities) was inserted into clean, clear tubing and connected between a ventilator and a resuscitation bag. Thirty-six ventilator hyperinflation breaths were applied for each 5% incremental increase in IRT between 0% and 20%. Main outcome measures The primary outcome was sputum displacement (cm). Secondary outcomes included PIF:PEF ratio and net PEF. Results Significant cephalad sputum movement of 2.42 cm (1.59 to 3.94) occurred with IRT between 5% and 20%, compared with caudad movement of 0.53 cm (0.31 to 1.53) at 0% IRT (median sputum movement difference 3.7 cm, 95% confidence interval 2.2 to 4.8, P Conclusions Significant increases in sputum movement occurred when IRT percentage was lengthened to achieve the optimal PIF:PEF ratio, irrespective of sputum viscosity. This provides a theoretical rationale for therapists to consider this technique when treating mechanically ventilated patients. As no additional sputum movement was seen beyond the critical PIF:PEF ratio threshold, a low IRT percentage may potentially be used to achieve effective sputum movement. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0031940618301755 |
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