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Positive Airway Pressure in Pleural Effusion

This document provides a trial protocol for a randomized controlled trial that will evaluate the efficacy of adding positive airway pressure to conventional chest physiotherapy in resolving pleural effusions after drainage. The trial aims to recruit 156 patients from two university hospitals to receive either positive airway pressure plus conventional chest physiotherapy, conventional chest physiotherapy alone, or a control group receiving non-therapeutic positive airway pressure. Outcome measures will include duration of chest drainage, length of hospital stay, changes in lung function and oxygen saturation, and incidence of pulmonary complications. The researchers hypothesize that optimizing lung expansion with positive airway pressure will accelerate pleural effusion resolution and improve patient outcomes.

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40 views1 page

Positive Airway Pressure in Pleural Effusion

This document provides a trial protocol for a randomized controlled trial that will evaluate the efficacy of adding positive airway pressure to conventional chest physiotherapy in resolving pleural effusions after drainage. The trial aims to recruit 156 patients from two university hospitals to receive either positive airway pressure plus conventional chest physiotherapy, conventional chest physiotherapy alone, or a control group receiving non-therapeutic positive airway pressure. Outcome measures will include duration of chest drainage, length of hospital stay, changes in lung function and oxygen saturation, and incidence of pulmonary complications. The researchers hypothesize that optimizing lung expansion with positive airway pressure will accelerate pleural effusion resolution and improve patient outcomes.

Uploaded by

Rin4l
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Journal of Physiotherapy 61 (2015) 93

Journal of
PHYSIOTHERAPY
journal homepage: www.elsevier.com/locate/jphys

Appraisal Trial Protocol

Efficacy of the addition of positive airway pressure to conventional chest


physiotherapy in resolution of pleural effusion after drainage:
protocol for a randomised controlled trial
Elinaldo da Conceição dos Santos a,b, Adriana Claudia Lunardi a,c
a
Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo; b Department of Biological and Health Sciences, Universidade Federal do Amapá;
c
Department of Physical Therapy of School of Medicine, University of São Paulo, São Paulo, Brazil

Abstract

Introduction: Chest drainage for pleural effusion can cause pain on chest radiography, as assessed by a blinded physician. Duration of
and changes in respiratory function. It can also increase the risk of chest drainage, length of hospital stay, and any pulmonary
pulmonary complications and impair functional ability, which may complications diagnosed during hospitalisation will be recorded.
increase length of hospital stay and the associated costs. For these Analysis: Intention to treat using: survival analysis for duration of
reasons, surgical and clinical strategies have been adopted to chest drainage, and length of hospital stay; analysis of variance for
reduce the duration of chest drainage. Objectives: To evaluate the chest-tube output, lung function and peripheral oxygen saturation;
efficacy of the addition of intermittent positive airway pressure and chi-square tests for comparing the incidence of pulmonary
applied by the Muller reanimator via a rubber facial mask versus complications between groups. Discussion: Conventional chest
conventional physiotherapy on the duration of chest drainage physiotherapy and intermittent positive airway pressure breathing
(primary objective), and its effect on the recovery of respiratory are widely indicated for people with pleural effusion and chest
function, length of hospital stay and incidence of pulmonary drains; however, no studies have evaluated the real benefit of this
complications (secondary objectives). Design: Randomised, con- type of treatment. Our hypothesis is that optimised lung expansion
trolled trial. Participants and setting: Inpatients with pleural achieved through the application of intermittent positive airway
effusion, aged over 18 years, who have had chest drainage in situ pressure will accelerate the reabsorption of pleural effusion,
for < 24 hours will be recruited from two university hospitals. decrease the duration of chest drainage and respiratory system
Patients will be excluded if they have any contraindication for the impairment, reduce the length of hospital stay, and reduce the
use of non-invasive positive airway pressure. Intervention and incidence of pulmonary complications.
control groups: After initial assessments of lung function,
156 patients will be randomised into a positive airway pressure
group (positive airway pressure at 15 cmH2O plus conventional
Trial registration: ClinicalTrials.gov. Registration number:
chest physiotherapy), a conventional chest physiotherapy group
NCT02246946. Was this trial prospectively registered: Yes, date:
(conventional chest physiotherapy plus non-therapeutic positive
16 September 2014. Funded by: Conselho Nacional de Desenvolvi-
airway pressure at 4 cmH2O) or a control group (non-therapeutic
mento Cientı́fico e Tecnológico-CNPq. Funder approval number:
positive airway pressure at 4 cmH2O). All groups will receive
442709/2014-5. Anticipated completion: September 2016. Corre-
treatment three times per day for 7 consecutive days. Measure-
spondence: Dr Adriana Claudia Lunardi, Master’s and Doctoral Pro-
ments: A blinded assessor will conduct all assessments. Peripheral
grams in Physical Therapy, Universidade Cidade de São Paulo, São
oxygenation and chest drainage output will be measured over
Paulo, Brazil. Email: [email protected]
7 consecutive days. Lung function will be re-assessed on Day 4 and
Day 8. The criteria for removal of the chest drain will be a Full protocol: Available on the eAddenda at doi:10.1016/j.jphys.
transudate output  200 ml over 24 hours and full lung expansion 2014.11.016

http://dx.doi.org/10.1016/j.jphys.2014.11.016
1836-9553/ß 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

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