Comparing Standard and Optimized Mechanical Insufflation-Exsufflation Settings for Clearing Airway Mucus in Critically Ill Adults on Invasive Ventilation

What this Trial Is About

Researchers are evaluating the effects of mechanical insufflation-exsufflation MI-E with optimized settings compared to standard settings on the volume of wet mucus suctioned in critically ill patients who require invasive mechanical ventilation MV for more than 48 hours. The study addresses retention of airway secretions, a common complication caused by excessive mucus and ineffective clearance, which can lead to serious lung problems and increased risks for these patients. The goal is to find better MI-E settings to help clear secretions more effectively, improving patient outcomes in intensive care. The study compares two MI-E approaches an optimized setting tailored to achieve inspiratory volumes of at least 1 liter and peak expiratory flow PEF of at least 80 Lmin, and a standard setting using fixed inspiratory and expiratory pressures of 40-40 cmH2O with set timing cycles. Both settings use a mechanical device to simulate coughing by delivering positive pressure to inflate the lungs followed by rapid negative pressure to enhance mucus clearance. Each intervention includes 4 sets of 5 breathing cycles with breaks to maintain oxygen levels. Participants will be monitored closely during the interventions with measurements including sputum volume suctioned immediately after treatment, respiratory parameters like inspiratory and peak expiratory flow, lung mechanics, heart rate, blood pressure, and oxygen levels before and after procedures. Safety is tracked by recording any adverse events during and immediately after interventions. The study runs until December 2028 and is designed to gather detailed data to help improve respiratory care for ventilated patients.

Effects of Mechanical Insufflation-Exsufflation With Optimized Settings on Wet Mucus Volume During Invasive Ventilation