Thoracic Fracture Clinical Trial
Official title:
Effect of Positive Expiratory Pressure on the Management of Chest Trauma: a Randomized Controlled Trial
Chest trauma (CT) are a common problem in our environment caused mainly by traffic accidents
and causal and domestic accidents among the elderly population. CTs, in some situations, can
lead to sequelae such as fibrothorax secondary to hemothorax and / or empyema and residual
chronic pain. Clinical regulations and guidelines recommend a guideline for chest
physiotherapy (CP) for all patients with rib fractures, but there is little scientific
evidence. It would be interesting to establish CP treatment protocols and describe the most
appropriate techniques according to the type and stages of thoracic trauma consolidation.
Objective: To evaluate the effect of Positive Expiratory Pressure (PEP) breathing added to
conventional CP in terms of aid secretion clearance, pain control, pleuropulmonary
radiological abnormalities, restoration of lung function, and admission days in the immediate
phase of the CT.
After acceptance to participate in the study, patients will be computerized randomized into 2
groups:
- PEP group: positive expiratory pressure breathing.
- CONTROL group: conventional CP treatment without positive pressure brething. The period
between day 0 and 20 days post-trauma is considered an immediate phase of CT.
Once admitted, an initial evaluation by the doctor will be performed, and pleuro-pulmonary
complications, the presence of respiratory failure, and pain control will be evaluated. The
chest physiotherapist will perform a clinical and secretion assessment using the Seva test
and a dynamic costal examination. The medical treatment of pain control will begin, and the
treatment of CP will begin, where it will be randomized in 2 groups: 1- PEP group: positive
expiratory pressure breathing with the help of a PEP bottle device. 2-CONTROL group:
conventional CP treatment without positive pressure breathing will be daily FR sessions, on
weekdays. Upon admission, hospital discharge and post-discharge, radiological checks (simple
radiography) will be performed and forced vital capacity will be measured with forced
spirometry.
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