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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02553200
Other study ID # KKU
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date January 2016
Est. completion date February 28, 2018

Study information

Verified date December 2015
Source Khon Kaen University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The efficacy of breathing exercise with oscillated inspiratory loading and oscillated positive expiratory pressure for airway secretion clearance and lung function in intubated patients, both with and without mechanical ventilation dependence


Description:

Effective strategies to increase mucus clearance rate has been suggested to depend on 4 factors.

1. Oscillation at proper frequency.

2. Lung volume and airway opening.

3. Expiratory flow rate or expiratory bias.

4. Humidifying of inspired air.

Multifunctional breathing device, the BreatheMAX, is the only breathing device made in Thailand. The BreatheMAX device possess many properties or techniques that benefit for respiratory care particularly 3 in 4 mechanisms for secretion clearance. The unique important aspect is the simultaneously providing several beneficial effects in one breath which are 1) Oscillation in the range of ciliary beat frequency 2) Biofeedback of respiratory effort that could encourage the deeper breathing performance, 3) Humidifier of inspired air, 4) Loaded breathing for inspiratory muscle training and generate PEP. These 4 functions would be very useful for increase secretion clearance particularly in more peripheral airway which are the most difficult to be cleared and be a risk of atelectasis and infection in patients with MV whose natural secretion clearance mechanisms are compromised, respiratory muscle weakness weak and low immunity.

Therefore, the combination of inspiratory and expiratory breathing exercise through the BreatheMAX breathing device may increase or promote more secretion clearance and improve lung function than expiratory breathing exercise alone in intubated patients, both with and without mechanical ventilation dependence


Recruitment information / eligibility

Status Completed
Enrollment 28
Est. completion date February 28, 2018
Est. primary completion date February 28, 2018
Accepts healthy volunteers No
Gender All
Age group N/A and older
Eligibility Inclusion Criteria:

- Intubated patients (with and without mechanical ventilator support) with secretion 1.5 ml/h, If the patients are breathing with mechanical ventilation, the PEEP level must be less than 6 centimeter of water and one of following

- Clinical and radiologic diagnosis of pulmonary infection

- Acute or chronic airway inflammation disease such as pneumonia, bronchiectasis, chronic obstructive pulmonary disease or chronic bronchitis and at least one sign of secretion accumulation in bronchial such as medium-coarse crackle, wheezing, persistent rhonchi and decrease breath sound

- Stable of cardiopulmonary function at least 2 days before the study and the patients don't receive the vasopressors drug within 5 days before collects the data

- Stable of hydration status or positive fluid balance at least 2 days before collects the data

- Ability to breathe or tolerate spontaneously breathing trial with T-piece at least 2 minutes with fraction of inspired oxygen less than 0.4 and without developing hypoxemia

- Good conscious and well cooperation

Exclusion Criteria:

- Pneumothorax (nontreated)

- Massive hemoptysis

- Acute myocardial infarction (with angina chest pain)

- High intracranial pressure (>20 mm Hg)

- Major arrhythmia

Study Design


Related Conditions & MeSH terms


Intervention

Device:
BreatheMAX (OPEP)
for 10 breathes/set, 10 sets/day and rest 1 minute between set
BreatheMAX (OIS and OPEP)
for 10 breathes/set, 10 sets/day and rest 1 minute between set
BreatheMAX (unload and non-oscillated)
for 10 breathes/set, 10 sets/day and rest 1 minute between set

Locations

Country Name City State
Thailand Sujittra Kluayhomthong Khon Kaen

Sponsors (1)

Lead Sponsor Collaborator
Khon Kaen University

Country where clinical trial is conducted

Thailand, 

Outcome

Type Measure Description Time frame Safety issue
Primary change from baseline in secretion wet weight (gram) between 3 hours before and after breathing exercise program The mucus secretion will be collected by nursing staff using sterile suctioning technique via tracheostomy (TT) or endotracheal (ET) tube, without adding any saline or sterile water, the timing of suction procedure depend on the secretion sound in the ET and TT tube. the secretion will be collected between 3 hours before start breathing exercise program and 3 hours after end of breathing exercise program in each day
Secondary change from baseline in dynamic compliance (Cdyn) at end of breathing exercise program as follows: Cdy, PIP, VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
the data will be recorded from the mechanical ventilator monitoring during the patients breathing with mechanical ventilation (MV) at least 1 minute
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in peak inspiratory pressure (PIP) at end of breathing exercise program as follows: Cdy, PIP,VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
the data will be recorded from the mechanical ventilator monitoring during the patients breathing with mechanical ventilation at least 1 minute
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in expired minute ventilation (VE) at end of breathing exercise program as follows: Cdy, PIP, VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
the wright respirometer will be connected with ET or TT tube during spontaneous breathing (off MV) for 1 minute, three measurement will be measured and rest 1 minute by using mechanical ventilation
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in slow vital capacity (SVC) at end of breathing exercise program as follows: Cdy, PIP, VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
the wright respirometer will be connected with ET or TT tube during spontaneous breathing (off MV), three measurement will be measured and rest 1 minute by using mechanical ventilation
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in lung sound at the end of breathing exercise program as follows: Cdy, PIP, PNIP, VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
the electronic stethoscope will be used to record the lung sound in each area during breathing with mechanical ventilation
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in Rating of Perceived Exertion (RPE) and Rating of Perceived Breathlessness (RPB) at the end of breathing exercise program as follows: Cdy, PIP, VE, SVC, PEFR, Lung sound, RPE and RPB and cardiopulmonary response
using the dyspnea and exertion scale
within 30 minutes before breathing exercise and 30 minute after breathing exercise
Secondary change from baseline in heart rate at the end of breathing exercise program the data will be recorded every minute 5 minutes before breathing exercise and during breathing exercise and 5 minute after breathing exercise
Secondary change from baseline in partial pressure of oxygen saturation at the end of breathing exercise program the data will be recorded every minute 5 minutes before breathing exercise and during breathing exercise and 5 minute after breathing exercise
Secondary change from baseline in respiratory rate at the end of breathing exercise program the data will be recorded every minute 5 minutes before breathing exercise and during breathing exercise and 5 minute after breathing exercise
Secondary change from baseline in blood pressure at the end of breathing exercise program 5 minutes before breathing exercise and 5 minute after breathing exercise