Lung hyperinflation by mechanical ventilation versus isolated tracheal aspiration in the bronchial hygiene of patients undergoing mechanical ventilation.
OBJECTIVE
To determine the efficacy of lung hyperinflation maneuvers via a mechanical ventilator compared to isolated tracheal aspiration for removing secretions, normalizing hemodynamics and improving lung mechanics in patients on mechanical ventilation.


METHODS
This was a randomized crossover clinical trial including patients admitted to the intensive care unit and on mechanical ventilation for more than 48 hours. Patients were randomized to receive either isolated tracheal aspiration (Control Group) or lung hyperinflation by mechanical ventilator (MVH Group). Hemodynamic and mechanical respiratory parameters were measured along with the amount of aspirated secretions.


RESULTS
A total of 50 patients were included. The mean age of the patients was 44.7 ± 21.6 years, and 31 were male. Compared to the Control Group, the MVH Group showed greater aspirated secretion amount (3.9g versus 6.4g, p = 0.0001), variation in mean dynamic compliance (-1.3 ± 2.3 versus -2.9 ± 2.3; p = 0.008), and expired tidal volume (-0.7 ± 0.0 versus -54.1 ± 38.8, p = 0.0001) as well as a significant decrease in peak inspiratory pressure (0.2 ± 0.1 versus 2.5 ± 0.1; p = 0.001).


CONCLUSIONS
In the studied sample, the MVH technique led to a greater amount of aspirated secretions, significant increases in dynamic compliance and expired tidal volume and a significant reduction in peak inspiratory pressure.
Centro Universitário Metodista, Porto Alegre, RS, Brazil.
Crisiela Brum
CB
Assmann
Hospital Cristo Redentor, Porto Alegre, RS, Brasil.
Paulo José Cardoso
PJ
Vieira
Hospital Cristo Redentor, Porto Alegre, RS, Brasil.
Fernanda
F
Kutchak
Centro Universitário Metodista, Porto Alegre, RS, Brazil.
Marcelo de Mello
Mde M
Rieder
Centro Universitário Metodista, Porto Alegre, RS, Brazil.
Soraia Genebra Ibrahim
SG
Forgiarini
Centro Universitário Metodista, Porto Alegre, RS, Brazil.
Luiz Alberto
LA
Forgiarini Junior
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D053120:Respiratory Aspiration / Q000378:metabolism; D015656:Respiratory Mechanics / Q000502:physiology*; D013990:Tidal Volume; D014132:Trachea / Q000378:metabolism*; D055815:Young Adult