Instrumental Respiratory Physiotherapy in Difficult-to-wean ICU Patients
ConditionVentilator Weaning
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorHospices Civils de Lyon
About this trial
Difficult ventilatory weaning is associated with a 20% mortality rate. 40% of these patients will develop intensive care unit (ICU)-acquired neuromyopathy, associated with reduced cough strength and a 4-fold increase in the risk of reintubation. The objective measure of cough strength is peak expiratory flow (PEF). Instrument-assisted coughing is a respiratory physiotherapy technique capable of significantly increasing PEF in chronic neuromuscular patients and draining bronchial secretions.
The objective of the study is to determine whether an early, systematic, instrumental, intensive respiratory physiotherapy strategy in patients with difficult ventilatory weaning and ICU-acquired neuromyopathy significantly improves PEF immediately prior to extubation, compared with a conventional, protocolized management strategy.
Eligibility criteria
Qualifiers
Patient 18 years or more, affiliated to a social security system
Patients on invasive mechanical ventilation for 48 hours or more
Failure of at least one mechanical ventilation weaning test (spontaneous breathing trial, SBT)
First successful SBT on the day of eligibility assessment
Disqualifiers
Recent brain injury (< 3 months, stroke, cardiopulmonary arrest)
Delirium tremens (Cushman score > 7)
Chronic neuromuscular pathology
Patient under continuous intravenous sedation
Trial design
Treatments tested in this trial
- Systematic and early intensive instrumental respiratory physiotherapy for patients undergoing difficult ventilatory weaning
- Protocolized standard-of-care respiratory physiotherapy
Treatment groups
50 Participants
are divided into 2 treatment groupsSponsors and collaborators
Source ClinicalTrials.gov