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PEEP-ZEEP Compared with Bag Squeezing and Chest Compression in Mechanically Ventilated Cardiac Patients: Randomized Crossover Clinical Trial

Author

Listed:
  • Taís Flores de Oliveira

    (Instituto de Cardiologia, Fundação Universitária de Cardiologia (IC/FUC), 395 Princesa Isabel Avenue, Porto Alegre 90620-001, Brazil)

  • Vinicius Serra Peringer

    (Instituto de Cardiologia, Fundação Universitária de Cardiologia (IC/FUC), 395 Princesa Isabel Avenue, Porto Alegre 90620-001, Brazil)

  • Luiz Alberto Forgiarini Junior

    (Department of Physiotherapy, Universidade La Salle (Unilasalle), Canoas 92010-000, Brazil)

  • Bruna Eibel

    (Instituto de Cardiologia, Fundação Universitária de Cardiologia (IC/FUC), 395 Princesa Isabel Avenue, Porto Alegre 90620-001, Brazil)

Abstract

Background and Objectives : Perform the bag squeezing and PEEP-ZEEP techniques associated with manual chest compression in mechanically ventilated cardiac patients in order to observe their effectiveness in the removal of pulmonary secretions and safety from a hemodynamic and ventilatory point of view. Methods: This is a randomized crossover clinical trial developed in a hospital in southern Brazil. We included hemodynamically stable male and female patients aged over 18 years who used invasive mechanical ventilation for at least 48 h. The control group was established for the bag-squeezing technique and the intervention group for the PEEP-ZEEP maneuver, both associated with manual chest compression. Tracheal aspiration was performed 2 h before in order to match the groups in relation to the volume of secretion, and also immediately at the end of the techniques in order to measure the amount of secretion collected. Results: The sample had 36 individuals with a mean age of 70.3 years, 21% of the patients were male, and the majority (10.4%) were hospitalized for ischemic heart disease. DBP ( p = 0.024), MAP ( p = 0.004) and RR ( p = 0.041) showed a significant difference in the post-moment in both groups. There was a significant difference in the reduction of peak pressure values ( p = 0.011), in the moment after performing the techniques, and also in the Cdyn ( p = 0.004) in the control group versus moment. Conclusions: Both maneuvers are safe in terms of hemodynamics and ventilatory mechanics, in addition to being capable of favoring airway clearance through secretion removal, and they can be used in routine physiotherapeutic care.

Suggested Citation

  • Taís Flores de Oliveira & Vinicius Serra Peringer & Luiz Alberto Forgiarini Junior & Bruna Eibel, 2023. "PEEP-ZEEP Compared with Bag Squeezing and Chest Compression in Mechanically Ventilated Cardiac Patients: Randomized Crossover Clinical Trial," IJERPH, MDPI, vol. 20(4), pages 1-8, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:2824-:d:1058631
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    References listed on IDEAS

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    1. Kenneth F Schulz & Douglas G Altman & David Moher & for the CONSORT Group, 2010. "CONSORT 2010 Statement: Updated Guidelines for Reporting Parallel Group Randomised Trials," PLOS Medicine, Public Library of Science, vol. 7(3), pages 1-7, March.
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