Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial

Trials

Study Protocol

Ana Márcia Delattre Zocolotti¹  Sibele Yoko Mattozo Takeda¹  Hipólito Carraro Junior²  Silvia Valderramas³  Marina Wolff Branco⁴  Daniela de Almeida Souza⁵ 

[1] Department of Prevention and Rehabilitation in Physiotherapy of the Universidade Federal Do Parana, Curitiba, PR, Brazil;Intensive Care Unit, Complexo Hospital de Clinicas, Curitiba, PR, Brazil;Internal Medicine and Health Sciences and Department of Prevention and Rehabilitation in Physical Therapy, Universidade Federal Do Parana, Curitiba, PR, Brazil;Internal Medicine and Health Sciences, Universidade Federal Do Parana, Avenida Coronel Francisco H. Dos Santos, 100, Caixa Postal 19031, Centro Politécnico, Jardim das Américas, 81531-980, Curitiba, PR, Brazil;Internal Medicine and Health Sciences, Universidade Federal Do Parana, Avenida Coronel Francisco H. Dos Santos, 100, Caixa Postal 19031, Centro Politécnico, Jardim das Américas, 81531-980, Curitiba, PR, Brazil;Physiotherapist from Empresa Brasileira de Serviços Hospitalares, Rio de Janeiro, Brazil;

关键词: Mechanical ventilators;    Stroke;    Intracranial pressure;    Respiratory mechanics;    Physical therapy techniques;    Randomized controlled trial;    Intracranial compliance;   

DOI  :  10.1186/s13063-023-07362-5

 received in 2022-03-16, accepted in 2023-05-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMechanical hyperinflation maneuver (MHM) is a technique known for optimizing bronchial hygiene and respiratory mechanics; however, its effects on intracranial compliance are not known.MethodsSixty patients aged ≥ 18 years, with clinical diagnosis of acute stroke, confirmed by neuroimaging examination, with onset of symptoms within 72 h, under mechanical ventilation through tracheal tube, will participate in this study. Participants will be randomly allocated into 2 groups: experimental group (n = 30)—MHM plus tracheal aspiration—and control group (n = 30)—tracheal aspiration only. Intracranial compliance will be measured by a non-invasive technique using Brain4care BcMM-R-2000 sensor. This will be the primary outcome. Results will be recorded at 5 times: T0 (start of monitoring), T1 (moment before MHM), T2 (moment after the MHM and before tracheal aspiration), T3 (moment after tracheal aspiration), T4, and T5 (monitoring 10 and 20 min after T3). Secondary outcomes are respiratory mechanics and hemodynamic parameters.DiscussionThis study will be the first clinical trial to examine the effects and safety of MHM on intracranial compliance measured by non-invasive monitoring. Limitation includes the impossibility of blinding the physical therapist who will supervise the interventions. It is expected with this study to demonstrate that MHM can improve respiratory mechanics and hemodynamic parameters and provide a safe intervention with no changes in intracranial compliance in stroke patients.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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