EIT-Guided Respiratory Physiotherapy for Prolonged Mechanical Ventilation (PMV)
Electrical Impedance Tomography-Guided Respiratory Physiotherapy for Liberation From Prolonged Mechanical Ventilation: A Multicenter Randomized Controlled Trial
Capital Medical University
200 participants
Feb 16, 2026
INTERVENTIONAL
Conditions
Summary
Patients with prolonged mechanical ventilation (PMV) frequently experience impaired ventilation distribution, respiratory muscle dysfunction, secretion retention, and delayed liberation from mechanical ventilation. Electrical impedance tomography (EIT) provides real-time bedside visualization of regional ventilation and enables individualized respiratory physiotherapy strategies. This multicenter randomized controlled trial aims to evaluate whether EIT-guided respiratory physiotherapy improves ventilator-free days at day 28 compared with conventional respiratory physiotherapy in adult patients with PMV. Respiratory physiotherapy consists of airway clearance, chest physiotherapy techniques, breathing pattern optimization, and therapeutic positioning. In the EIT-guided group, real-time EIT imaging is used to individualize physiotherapy strategies based on predefined ventilation distribution indicators, while the control group receives standardized physiotherapy according to institutional protocols without EIT guidance. Secondary outcomes include successful liberation from mechanical ventilation, diaphragm ultrasound parameters, EIT-derived ventilation distribution indices (exploratory mechanistic outcomes), ICU Mobility Scale, healthcare resource utilization, and safety outcomes.
Eligibility
Inclusion Criteria5
- Age ≥ 18 years.
- Invasive mechanical ventilation for ≥ 21 consecutive days.
- Clinically stable and eligible for respiratory physiotherapy as determined by the treating team.
- Expected to remain on invasive mechanical ventilation for at least 48 hours after enrollment.
- Written informed consent obtained from the patient or legally authorized representative.
Exclusion Criteria6
- Contraindications to electrical impedance tomography .
- Hemodynamic instability requiring high-dose vasoactive support.
- Severe hypoxemia refractory to optimization.
- Unstable fractures or other contraindications to mobilization or positioning.
- Pregnancy.
- Expected death within 48 hours.
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Interventions
Respiratory physiotherapy consists of airway clearance, chest physiotherapy techniques, breathing pattern optimization, and therapeutic positioning, individualized using real-time EIT guidance based on predefined ventilation distribution indicators. Link this intervention to: Experimental Arm
Respiratory physiotherapy consists of airway clearance, chest physiotherapy techniques, breathing pattern optimization, and therapeutic positioning, delivered according to standardized institutional protocols without EIT guidance. Link this intervention to: Control Arm
Locations(1)
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NCT07372794