The Effect of Oscillation and Lung Expansion (OLE) Therapy in Prolonged Mechanical Ventilated Patients With Atelectasis Evaluated in Multiple Methods

Capital Medical University

Status: Enrolling

Conditions: Atelectasis

Treatments: Other: Oscillation and lung expansion; Other: High frequency chest wall oscillation or other airway clearance therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07451405

20251211001

Details and patient eligibility

About

High frequency chest wall oscillation (HFCWO) is currently one of the most common and widespread mechanical airway clearance techniques (ACTs) in clinical practice in China. As an external airway oscillation technique, it has been proven in previous clinical practices that it can help clear secretions by vibrating the chest wall, loosening the secretions adhering to the airway walls and promoting ciliary movement, thereby improving lung ventilation and re-expansion. However, there are still some groups of patients for whom this technique is not suitable in clinical practice, such as those who are uncomfortable with the oscillation, have damaged skin on the chest and back, have unstable rib fractures, or have poorly positioned tracheostomy tubes. In recent years, integrating multiple techniques into a single treatment has become a trend. Among them, oscillation and lung expansion (OLE) combines continuous positive airway pressure (CPAP), continuous high-frequency oscillation (CHFO), and nebulization, which can effectively clear airway secretions and promote lung re-expansion. Currently, only a few studies have confirmed that OLE has a positive impact on improving respiratory function in patients with acute respiratory failure, severe burns, and after lung surgery.

This study aims to further compare the effects of the above two mechanical ACTs on improving lung ventilation and re-expansion by electrical impedance tomography (EIT), and optimize the clinical practice of physical therapists.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥18 years old
• The following characteristics of high mucus secretion in the airway occur along with pulmonary infection: coughing up a large amount of white sticky phlegm, yellow phlegm or yellow purulent phlegm; Phlegm sounds can be heard in the lungs. The frequency of sputum aspiration is higher than once every 4 hours
• Tracheotomy time ≥7 days
• Vital signs are stable.

Exclusion criteria

• Hemodynamic instability
• Inhaled oxygen concentration (FiO2) > 60%
• Untreated pneumothorax
• Patients who have undergone total pneumonectomy
• Hemoptysis
• Pulmonary bullae, etc.
• Patients with delirium and restlessness

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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60 participants in 2 patient groups, including a placebo group

Coventional therapy group

Placebo Comparator group

Description:

This group conducted casual treatment and airway clearance (except oscillation an lung expansion therapy)

Treatment:

Other: High frequency chest wall oscillation or other airway clearance therapy

OLE group

Experimental group

Description:

This group conducted casual treatment and oscillation an lung expansion on daily therapy

Treatment:

Other: High frequency chest wall oscillation or other airway clearance therapy

Other: Oscillation and lung expansion