Observation on the safety of vibration expectoration frequency in patients with severe craniocerebral injury
Objective To evaluate the safety and effect of mechanical vibration sputum evacuation at different frequencies on vi-tal signs,intracranial pressure(ICP),and cerebral perfusion pressure(CPP)in patients with severe traumatic brain injury at risk of increased ICP.Methods Forty patients with severe traumatic brain injury under continuous ICP monitoring admitted to the intensive care unit of the neurosurgery department of Yijishan Hospital,Wannan Medical College from November 2020 to July 2023 were random-ly divided into two groups.The first group of patients underwent high-frequency sputum evacuation on the first day and low-frequency sputum evacuation on the second day,and frequency data were collected.The other group of patients used low-frequency sputum evacua-tion on the first day and high-frequency sputum evacuation method on the second day.The high-frequency vibration frequency was set at 35 Hz,and the low-frequency at 20 Hz.Two groups of patients were included in the low-frequency group using low-frequency spu-tum data,and in the high-frequency group using high-frequency sputum data.ICP,CCP,mean arterial pressure(MAP),pulse oxygen saturation(SPO2),heart rate(HR),respiratory rate(RR),and sputum volume within 2 hours before and after mechanical vibration sputum evacuation were compared between the two groups.Blood gas analysis was performed half an hour before sputum evacuation on the first day and half an hour after on the second day to compare results.Results There was a statistically significant difference in HR before and during the procedure in the low-frequency group(P<0.05),with no significant differences in other parameters(P>0.05).In the high-frequency group,HR before and during the procedure and RR during and after the procedure showed significant differences(P<0.05),while there was no statistically significant difference in other indicators(P>0.05).Inter-group comparison revealed a signif-icant difference in HR changes between the high-frequency and low-frequency groups(P<0.05),while there was no statistically signif-icant difference in other indicators(P>0.05).Sputum retention increased in both groups after the procedure,with a higher volume in the high-frequency group compared to the low-frequency group(P<0.05).Blood gas analysis showed a significant difference in PaCO2 be-fore and after the procedure(P<0.05),while there was no statistically significant difference in other indicators(P>0.05).Conclusion Mechanical vibration sputum evacuation aids in improving airway secretion clearance,with better drainage effects at higher frequen-cies.Patients with severe traumatic brain injury who are at risk of ICP can benefit from sputum expulsion at higher vibration frequencies.
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