Lung Recruitment During Chest Physiotherapy in Mechanically Ventilated Patients

Recruiting now · Not applicable

Conditions studied: Intensive Care, Invasive Mechanical Ventilation, Chest Physiotherapy, Airway Clearance

In brief

In intensive care, respiratory physiotherapy is an integral part of the daily care of patients under invasive mechanical ventilation. Its goals are to improve the clearance of bronchial secretions to allow for the resolution of atelectasis and alveolar recruitment, thereby enhancing respiratory mechanics and gas exchange. The most widespread technique in France is external expiratory compression of the chest. The effectiveness of this technique depends on the selection of patients (it seems to be more effective in patients with higher secretion levels) and on the practical implementation of the technique (favoring brief and vigorous compressions at the beginning of expiration). However, the effect of the artificial ventilator settings, particularly the ventilatory mode used during the respiratory physiotherapy session, has never been evaluated. The two most commonly used ventilatory modes worldwide are Volume Assist Control Ventilation (V-ACV) and pressure support ventilation (PSV). In this unit, respiratory physiotherapy under artificial ventilation is performed daily on patients with artificial ventilation with abundant secretions, regardless of the ventilatory mode.

Key facts

Study ID

NCT06805357

Run by

Assistance Publique - Hôpitaux de Paris

People needed

40

Starts

2024-07-23

Expected to finish

2027-06-23

Last updated by the study team

2026-01-15

Who can join

Age: 18 and older, up to 100. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patient under assisted ventilation (in V-ACV or PSV) triggering all ventilator cycles
• Patient deemed " secretive ": requiring ≥ 2 tracheal aspirations every 3 hours
• Patient (or relative) who has given consent to participate in the research
• Patient covered by social security

You may not qualify if…

• Age under 18 years
• Legal guardian required
• Recent cardiac and/or thoracic and/or abdominal surgery (< 3 months)
• Rib fracture(s)
• Pneumothorax and/or presence of a chest drain
• Recent neurosurgery (< 3 months) and/or proven or suspected increased intracranial pressure (ICP)
• Hemodynamic instability defined as: noradrenaline ≥ 1mg/h, adrenaline ≥ 0.5 mg/h, dobutamine ≥ 5γ/kg/min.
• Respiratory instability defined as: PEEP > 10 cmH2O and/or PaO2/FiO2 < 150 mm Hg
• Pregnancy
• Hemoptysis
• Sever skin lesions (e.g., burns, Lyell's syndrome)
• Patient under foreign health insurance

Where it is running

• Intensive Care Medicine Department Henri Mondor Hospital — Créteil, France (enrolling)

Full record on ClinicalTrials.gov

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