Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial
Abstract Background Mechanical hyperinflation maneuver (MHM) is a technique known for optimizing bronchial hygiene and respiratory mechanics; however, its effects on intracranial compliance are not known. Methods Sixty patients aged ≥ 18 years, with clinical diagnosis of acute stroke, confirmed by n...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-023-07362-5 |
| _version_ | 1797817794457239552 |
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| author | Daniela de Almeida Souza Marina Wolff Branco Hipólito Carraro Junior Ana Márcia Delattre Zocolotti Sibele Yoko Mattozo Takeda Silvia Valderramas |
| author_facet | Daniela de Almeida Souza Marina Wolff Branco Hipólito Carraro Junior Ana Márcia Delattre Zocolotti Sibele Yoko Mattozo Takeda Silvia Valderramas |
| author_sort | Daniela de Almeida Souza |
| collection | DOAJ |
| description | Abstract Background Mechanical hyperinflation maneuver (MHM) is a technique known for optimizing bronchial hygiene and respiratory mechanics; however, its effects on intracranial compliance are not known. Methods Sixty 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. Discussion This 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. |
| first_indexed | 2024-03-13T08:58:44Z |
| format | Article |
| id | doaj.art-b6b9a1d166e348729ee12c66ee369fc9 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-03-13T08:58:44Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-b6b9a1d166e348729ee12c66ee369fc92023-05-28T11:27:00ZengBMCTrials1745-62152023-05-0124111010.1186/s13063-023-07362-5Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trialDaniela de Almeida Souza0Marina Wolff Branco1Hipólito Carraro Junior2Ana Márcia Delattre Zocolotti3Sibele Yoko Mattozo Takeda4Silvia Valderramas5Internal Medicine and Health Sciences, Universidade Federal Do ParanaInternal Medicine and Health Sciences, Universidade Federal Do ParanaIntensive Care Unit, Complexo Hospital de ClinicasDepartment of Prevention and Rehabilitation in Physiotherapy of the Universidade Federal Do ParanaDepartment of Prevention and Rehabilitation in Physiotherapy of the Universidade Federal Do ParanaInternal Medicine and Health Sciences and Department of Prevention and Rehabilitation in Physical Therapy, Universidade Federal Do ParanaAbstract Background Mechanical hyperinflation maneuver (MHM) is a technique known for optimizing bronchial hygiene and respiratory mechanics; however, its effects on intracranial compliance are not known. Methods Sixty 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. Discussion This 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.https://doi.org/10.1186/s13063-023-07362-5Mechanical ventilatorsStrokeIntracranial pressureRespiratory mechanicsPhysical therapy techniquesRandomized controlled trial |
| spellingShingle | Daniela de Almeida Souza Marina Wolff Branco Hipólito Carraro Junior Ana Márcia Delattre Zocolotti Sibele Yoko Mattozo Takeda Silvia Valderramas Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial Trials Mechanical ventilators Stroke Intracranial pressure Respiratory mechanics Physical therapy techniques Randomized controlled trial |
| title | Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial |
| title_full | Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial |
| title_fullStr | Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial |
| title_full_unstemmed | Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial |
| title_short | Mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients: protocol for a randomized controlled equivalence trial |
| title_sort | mechanical hyperinflation maneuver and intracranial compliance of critical neurological patients protocol for a randomized controlled equivalence trial |
| topic | Mechanical ventilators Stroke Intracranial pressure Respiratory mechanics Physical therapy techniques Randomized controlled trial |
| url | https://doi.org/10.1186/s13063-023-07362-5 |
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