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Journal of Clinical Monitoring and Computing

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Open Access 06-01-2023 | Cough | Original Research

Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study

Authors: Eugenio Garofalo, Serena Rovida, Gianmaria Cammarota, Eugenio Biamonte, Letizia Troisi, Leonardo Cosenza, Corrado Pelaia, Paolo Navalesi, Federico Longhini, Andrea Bruni

Published in: Journal of Clinical Monitoring and Computing | Issue 3/2023

Abstract

Clearance of secretions remains a challenge in ventilated patients. Despite high-frequency percussive ventilation (HFPV) showing benefits in patients with cystic fibrosis and neuromuscular disorders, very little is known about its effects on other patient categories. Therefore, we designed a physiological pilot study investigating the effects on lung aeration and gas exchange of short HFPV cycles in tracheostomized patients undergoing mechanical ventilation. Electrical impedance tomography (EIT) was recorded at baseline (T0) by a belt wrapped around the patient's chest, followed by the HFPV cycle lasting 10 min. EIT data was collected again after the HFPV cycle (T1) as well as after 1 h (T2) and 3 h (T3) from T0. Variation from baseline of end-expiratory lung impedance (∆EELI), tidal variation (TIV) and global inhomogeneity index (GI) were computed. Arterial blood was also taken for gas analysis. HFPV cycle significantly improved the ∆EELI at T1, T2 and T3 when compared to baseline (p < 0.05 for all comparisons). The ratio between arterial partial pressure and inspired fraction of oxygen (PaO₂/FiO₂) also increased after the treatment (p < 0.001 for all comparison) whereas TIV (p = 0.132) and GI (p = 0.114) remained unchanged. Short cycles of HFPV superimposed to mechanical ventilation promoted alveolar recruitment, as suggested by improved ∆EELI, and improved oxygenation in tracheostomized patients with high load of secretion.

Trial Registration Prospectively registered on www.clinicaltrials.gov (NCT05200507; dated 6th January 2022).

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Title: Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study
Authors: Eugenio Garofalo
Serena Rovida
Gianmaria Cammarota
Eugenio Biamonte
Letizia Troisi
Leonardo Cosenza
Corrado Pelaia
Paolo Navalesi
Federico Longhini
Andrea Bruni
Publication date: 06-01-2023
Publisher: Springer Netherlands
Keywords: Cough
Cough
Cough
Published in: Journal of Clinical Monitoring and Computing / Issue 3/2023
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-022-00970-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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