Jet or vibrating mesh nebulisation for secretion management in ICU
Research type
Research Study
Full title
Can continuous or intermittent normal saline nebulisation via a vibrating mesh nebuliser or intermittent normal saline via a standard jet nebuliser improve the lung physiology and secretion viscosity in mechanically ventilated patients with a Heat Moisture Exchange (HME) in the circuit?
IRAS ID
271083
Contact name
Malcolm A. B. Sim
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde Health Board
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Patients in Intensive Care who are requiring help to breath from a ventilator (breathing machine)often have troublesome sectretions which can be difficult to clear from the lungs. This is multifactorial and includes respiratory muscle weakness, impaired cough and low conscious level. The secretion load itself can be high due to intercurrent infection. High secretion load is a major risk factor for deterioration when the patient is extubated (there breathing tube removed and disconnection from the ventilator). Subsequently having to be put back on the ventilator is associated with a worse outcome.
Secretion management is an important issue. The mainstay of treatment is physiotherapy, suctioning of the secretions and nebulisation of saline (salty water) into the lungs to loosen secretions. A nebulisrer is a device which creates a fine mist of saline or a drug which enables the saline to get deep into the lungs and help moisten secretions.
Traditionally jet nebulisers have been used in Intensive Care. These work by forcing air or oxygen through a liquid to form an aerosol (mist). A more recent development is the vibrating mesh technology. Nebulisers based on this have a mesh with many tiny precision formed holes. When energy is applied to the mesh a very fine aerosol is generated. There is already evidence that this method produces a much finer aerosol able to better penetrate and deposit into the airways of the lungs.
What is not known is whether nebulising saline via the traditional jet nebuliser or vibrating mesh technology is better at loosening secretions. In this study we aim to compare the viscosity of respiratory sections after saline has been nebulised using a vibrating mesh nebuliser or a traditional jet nebuliser. This will be by means of a Qualitative Sputum Assesment Tool. We will also record a number of respiratory physiological parameters.
REC name
Scotland A: Adults with Incapacity only
REC reference
19/SS/0116
Date of REC Opinion
2 Dec 2019
REC opinion
Further Information Favourable Opinion