Efficacy of Infection-site-targeted Postural Drainage in Mechanically Ventilated ICU Patients With Pulmonary Infection

Affiliated Hospital of Jiangnan University384 enrolled

Overview

This single-center, 1:1 randomized controlled trial aimed to evaluate the efficacy of infection-site-targeted postural drainage combined with mechanical vibration for mechanically ventilated ICU patients with pulmonary infection. Eligible subjects were randomly assigned to either the personalized-care group (PCG, intervention) or routine-care group (RCG, control). Patients in PCG received imaging-guided infection-site-targeted postural drainage plus mechanical vibration. Patients in RCG received standard routine position changes and mechanical vibration without imaging-guided targeted positional adjustment. The primary outcome was duration of invasive mechanical ventilation. Secondary outcomes included PaO₂/FiO₂ ratio, ICU length of stay, total hospital length of stay, and 28-day all-cause mortality.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

384

Conditions

Pulmonary Infection Mechanical Ventilation Respiratory Failure

Imaging-guided infection-site-targeted postural drainage plus mechanical vibration chest physiotherapy.PROCEDURE

Imaging-guided infection-site-targeted postural drainage combined with mechanical vibration chest physiotherapy. The body position is individually adjusted according to pulmonary infection location shown on imaging examinations to facilitate sputum drainage.

Routine position change combined with mechanical vibrationPROCEDURE

Routine regular position change combined with mechanical vibration chest physiotherapy. No imaging-guided targeted positional adjustment is performed; body position is changed following standard ICU nursing protocol only.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Aged 18-80 years old; 2. Admitted to ICU and receiving invasive mechanical ventilation; 3. Clinically confirmed pulmonary infection; 4. Enrolled between May 2022 and October 2024. Exclusion Criteria: 1. Unstable systemic disease contraindicating postural changes; 2. Active bleeding (gastrointestinal, intracranial, or pulmonary); 3. Requirement for continuous renal replacement therapy; 4. Raised intracranial pressure; 5. Neuromuscular disorder; 6. Multiple fractures or major trauma; 7. Severe hemodynamic instability; 8. Significant arrhythmias; 9. Severe delirium or altered mental status; 10. Pregnancy or lactation; 11. Currently participating in another interventional clinical trial.

Outcomes

Primary Outcomes

Duration of mechanical ventilation

Time frame: From initiation of invasive mechanical ventilation until successful extubation or death, assessed up to day 28.

Secondary Outcomes

28-day mortality

Time frame: All-cause mortality assessed at 28 calendar days from the date of randomization

PaO₂/FiO₂ ratio

Time frame: Measured at baseline (X1), Day 1, Day 2, Day 3, Day 4 post-randomization (X2-X4), and at weaning preparation (X5), all within 28 calendar days from randomization

ICU length of stay

Time frame: From randomization until ICU discharge, assessed up to 28 calendar days from randomization

Total hospital length of stay

Time frame: From randomization until hospital discharge, assessed up to 28 calendar days from randomization