The feasibility of using mouthpiece ventilation post-extubation for acute tetraplegia in the Intensive Care Unit
About the Project
Hopkins Centre CIs Co-Investigators: Brooke Wadsworth, Peter Kruger, Craig Hukins, Jenny Paratz, Chris Joyce, Gabrielle Ferguson, Duncan Brown, Brooke Duggan, Tim Geraghty, Adam Semciw
Objective: To explore the feasibility of mouthpiece ventilation (MPV) use in the intensive care environment for patients who are extubated after suffering a cervical spinal cord injury and the barriers and enablers from a practice perspective.
About this project: This project develops, applies and measures a new clinical intervention technique/technology (MPV) that supports extubation of newly injured people with SCI.Whilst this study is a feasibility study, MPV appears to provide adequate post extubation breathing support and be well accepted by patient and staff participants. This study involves patient participants during the first few hours and days after injury. It aims to optimise breathing ability post extubation and allow participants to commence rehabilitation sooner with reduced respiratory complications. .
Status: Sixteen extubations have now been completed with participants using MPV. Matched cohort data has been retrieved to allow review of current treatment versus prior to MPV study. All clinical ICU staff have been educated with regard to MPV use and the study. Feedback has been received from all participants and staff involved. Investigators have now presented at several conferences and in-services.
Output/ impact: Whilst this study is a feasibility study, MPV appears to provide adequate post extubation breathing support and be well accepted by patient and staff participants. Feasibility study data will provide information to allow larger multi centre study to test if MPV can reduce extubation failure. The relationships developed throughout this feasibility have led to 3 other research proposals for the upcoming 12 months. These relationships extend into trauma services and also community programs. The use of pre-extubation outcome measures has gained interest from ICU staff and now been incorporated without prompting for this study.
The aims of this study are to:
1. determine the nature and the amount of assistance required to adequately implement MPV
2. determine patient experience and clinicians’ views on the practice i.e., time was involved; feasibility from a clinician and patient perspective; knowledge skills acuity issues; barriers and enablers to embedding it in routine clinical practice.
3. determine if any baseline characteristics are likely to influence the use of MPV
4. obtain preliminary data to inform a power analysis for the design of a definitive study to examine whether MPV has an impact on incidence of reintubation and ICU LOS.
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Researchers
Professor and Director
Physiotherapist, Spinal Injury Unit, PAH
