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Instrumental Respiratory Physiotherapy in Difficult-to-wean ICU Patients
Sponsor: Hospices Civils de Lyon
Summary
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.
Official title: Randomized Controlled Trial Evaluating the Impact of Intensive, Instrumental and Early Respiratory Physiotherapy on Peak Expiratory Flow in Mechanically Ventilated Patients With ICU-acquired Muscle Weakness
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
50
Start Date
2025-03-18
Completion Date
2027-05-01
Last Updated
2026-01-20
Healthy Volunteers
No
Conditions
Interventions
Systematic and early intensive instrumental respiratory physiotherapy for patients undergoing difficult ventilatory weaning
Patients randomized to this group will receive 3 sessions per day of intensive early respiratory physiotherapy with instrumental techniques from randomization to day 7, before and after any extubation. The strategy will be applied until day 7 of randomization, regardless of the patient's status (intubated or not).
Protocolized standard-of-care respiratory physiotherapy
Patients in this group will receive standardized and protocolized respiratory physiotherapy to reproduce the usual practices of non-expert centers,1 to 2 sessions of manual respiratory physiotherapy (not assisted by an instrumental technique) per day until the day of successful extubation, or until day 7 if necessary
Locations (3)
Service d'Anesthésie et Réanimation, Hôpital de la Croix Rousse, GHN
Lyon, France, France
Médecine Intensive - Réanimation, Hôpital de la Croix Rousse
Lyon, France
Département d'Anesthésie Réanimation - Médecine Intensive, Centre Hospitalier Lyon Sud
Lyon, France