New devices have been used in intensive care to optimize respiratory function in critically ill patients, such as automatic lateralization therapy. However, the times and angles used vary widely, and there is no clear evidence of cardiovascular safety and immediate effects, which represents a gap in the literature. This quasi-experimental study aims to evaluate the imediact efficacy and cardiorespiratory safety of automatic lateralization therapy in critically ill patients under invasive mechanical ventilation. The primary outcomes include changes in ventilation distribution and end-expiratory impedance variation. Secondary outcomes include respiratory mechanics, vital signs, and adverse events.
Introduction: Electrical impedance tomography (EIT) enables real-time imaging of lung ventilation, guiding interventions such as automatic lateralization therapy. Despite its potential, evidence about immediate effects and safety is limited. Objective: To evaluate the imediact cardiorespiratory efficacy and safety of automatic lateralization therapy in critically ill patients. Method: Quasi-experimental, non-randomized, two-arm study. Participants aged ≥18 years, intubated and clinically stable, will undergo both interventions. Interventions: * Arm 1: Supine position with head elevated at 30°. * Arm 2: Automatic lateralization therapy using programmable bed angles (0°, 15°, and 30°), alternating sides. Outcomes: Ventilation distribution, impedance variation (ΔZ, ΔEELZ), respiratory mechanics, adverse events, and vital signs will be measured. Ethical approval has been granted (CAAE 70188523.0.0000.5200). Informed consent will be obtained from legal guardians.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
10
Program the bed to vary angle and time continuously during the intervention
In this intervention, participants will be positioned in the supine position with the head of the bed elevated at 30°
Hospital Geral Otávio de Freitas
Recife, Pernambuco, Brazil
Electrical impedance tomography (EIT): End-Expiratory Electrical Impedance Variation (ΔEELZ)
Represents the change in regional pulmonary aeration between the pre- and post-intervention moments.
Time frame: In the 5 minutes of each angulation, totaling 15 minutes in the unilateral morphofunctional pattern or 20 minutes in the bilateral morphofunctional pattern.
Electrical impedance tomography (EIT): Ventilation Distribution Variation (ΔZ)
Represents the change in ventilation distribution before and after the intervention.
Time frame: In the 5 minutes of each angulation, totaling 15 minutes in the unilateral morphofunctional pattern or 20 minutes in the bilateral morphofunctional pattern.
Adverse events
Monitoring of serious and non-serious adverse events associated with the intervention through an adapted adverse event form
Time frame: In the 5 minutes of each angulation, totaling 15 minutes in the unilateral morphofunctional pattern or 20 minutes in the bilateral morphofunctional pattern.
Respiratory Mechanics
Data provided through the mechanical ventilator and from inspiratory and expiratory pause maneuvers
Time frame: In the 5 minutes of each angulation, totaling 15 minutes in the unilateral morphofunctional pattern or 20 minutes in the bilateral morphofunctional pattern.
Vital signs
Viewed on the multiparameter monitor
Time frame: In the 5 minutes of each angulation, totaling 15 minutes in the unilateral morphofunctional pattern or 20 minutes in the bilateral morphofunctional pattern.
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