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Non-invasive positive airway pressure added to chest physiotherapy promotes a faster resolution of pleural effusion after drainage: A randomised controlled trial

Elinaldo Santos, Marcela Vidal, Juliana Silva, Marcus Assis Filho, Moisés Monte, Adriana C. Lunardi
European Respiratory Journal 2016 48: PA4431; DOI: 10.1183/13993003.congress-2016.PA4431
Elinaldo Santos
1Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
3Physical Therapy, Faculdade de Macapá, Macapá, AmapáBrazil
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Marcela Vidal
3Physical Therapy, Faculdade de Macapá, Macapá, AmapáBrazil
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Juliana Silva
3Physical Therapy, Faculdade de Macapá, Macapá, AmapáBrazil
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Marcus Assis Filho
3Physical Therapy, Faculdade de Macapá, Macapá, AmapáBrazil
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Moisés Monte
3Physical Therapy, Faculdade de Macapá, Macapá, AmapáBrazil
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Adriana C. Lunardi
1Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil
2Physical Therapy, University of Sao Paulo, Sao Paulo, Brazil
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Abstract

AIM: To test the effects of non-invasive positive airway pressure added to CPT on resolution of pleural effusions after drainage.

METHODS: This trial (NCT02246946) enrolled 150 patients with pleural effusion and chest drainage in situ for <24h randomly assignedinto 3 groups: G1=Non-invasive positive pressure at 15cmH2O + CPT (n=51), G2=CPT (n=50) and G3=Control (sham intervention, n=49). All patients received 3 daily interventions until the drain was removed for a maximum of 7 days. Chest drainage output and X-ray (criteria for removal of drain=output over 24h ≤200ml + full lung expansion on X-ray) were assessed daily. Days of chest tube drainage, length of hospital stay, pulmonary complications (pneumonia, atelectasis, or lung entrapment) and side effect of positive pressure (aerophagia or pleural fistula) were recorded until hospital discharge. Outcome assessors and statisticians were blinded to the random allocation. ANOVA, Kaplan-Meier and chi-square tests were used.

RESULTS: G1 presented shorter chest tube drainage time (4±2 vs 6±6 vs 6±3; p<0.0001) and hospital stay (5±4 vs 7±7 vs 7±6; p<0.0001) compared to G2 and G3. In addition, G1 had decreased need for antibiotics (15% vs 36% vs 47%; p<0.0001) and a lower rate of pneumonia (0% vs 16% vs 20%; p=0.004) compared to G2 and G3. All groups has the same rate of side effect (9% vs 2% vs 6%; p>0.05).

CONCLUSION: The addition of positive pressure in the conventional therapy decreases the thoracic drainage time, hospitalization time, the rate of pulmonary complications and antibiotic use in patients with pleural effusion.

  • Physiotherapy care
  • Pleura
  • Non-invasive ventilation - acute respiratory failure
  • Copyright ©the authors 2016
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Non-invasive positive airway pressure added to chest physiotherapy promotes a faster resolution of pleural effusion after drainage: A randomised controlled trial
Elinaldo Santos, Marcela Vidal, Juliana Silva, Marcus Assis Filho, Moisés Monte, Adriana C. Lunardi
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4431; DOI: 10.1183/13993003.congress-2016.PA4431

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Non-invasive positive airway pressure added to chest physiotherapy promotes a faster resolution of pleural effusion after drainage: A randomised controlled trial
Elinaldo Santos, Marcela Vidal, Juliana Silva, Marcus Assis Filho, Moisés Monte, Adriana C. Lunardi
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4431; DOI: 10.1183/13993003.congress-2016.PA4431
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