Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol

Background Diaphragm dysfunction and inadequate chest wall and respiratory muscle function are common in critically ill patients who face difficulties in weaning from mechanical ventilation (MV). This can lead to secretion retention and impaired airway clearance. Chest physiotherapy (CPT) in these p...

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Main Authors: Hao Wang, Jianing Xi, Hongying Jiang
Format: Article
Language:English
Published: PeerJ Inc. 2025-08-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19727.pdf
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author Hao Wang
Jianing Xi
Hongying Jiang
author_facet Hao Wang
Jianing Xi
Hongying Jiang
author_sort Hao Wang
collection DOAJ
description Background Diaphragm dysfunction and inadequate chest wall and respiratory muscle function are common in critically ill patients who face difficulties in weaning from mechanical ventilation (MV). This can lead to secretion retention and impaired airway clearance. Chest physiotherapy (CPT) in these patients can help reduce secretion retention. This study protocol outlines an investigation into the feasibility and effectiveness of CPT guided by electrical impedance tomography (EIT) in difficult-to-wean patients on lung function, duration of mechanical ventilation, functional performance, and intensive care unit (ICU) hospitalization expenses. Methods This single-center, single-blind, randomized pilot study employed a parallel-group design. Participants will be randomly assigned to either an intervention group receiving EIT-guided CPT or a control group receiving only experiential CPT Interventions, lasting 20 minutes each, were administered up to twice daily from ICU admission until discharge. The assessments will occur before interventions, after the 14 days, and after the 28 days. Outcome measures will be collected at before and after the intervention, peak expiratory flow, 30-day weaning success rate, maximum inspiratory pressure, diaphragm thickening rate, diaphragmatic excursion, ICU stay duration, and days from baseline to MV removal or Day 30. Adverse events will be documented. Conclusion This study will evaluate the feasibility and effectiveness of EIT-guided CPT versus conventional CPT in difficult-to-wean patients. If successful, this approach could enhance the efficiency of CPT. Trial registration This study was prospectively registered at the National Library of Medicine (https://clinicaltrials.gov/; reference: NCT06677099; Date of registration: 5th November 2024).
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spelling doaj-art-38ab6ac2644541c296ee3c7f1bf60dde2025-08-20T03:44:43ZengPeerJ Inc.PeerJ2167-83592025-08-0113e1972710.7717/peerj.19727Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocolHao Wang0Jianing Xi1Hongying Jiang2Beijing Rehabilitation Hospital, Capital Medical University, Beijing, ChinaBeijing Rehabilitation Hospital, Capital Medical University, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, ChinaBackground Diaphragm dysfunction and inadequate chest wall and respiratory muscle function are common in critically ill patients who face difficulties in weaning from mechanical ventilation (MV). This can lead to secretion retention and impaired airway clearance. Chest physiotherapy (CPT) in these patients can help reduce secretion retention. This study protocol outlines an investigation into the feasibility and effectiveness of CPT guided by electrical impedance tomography (EIT) in difficult-to-wean patients on lung function, duration of mechanical ventilation, functional performance, and intensive care unit (ICU) hospitalization expenses. Methods This single-center, single-blind, randomized pilot study employed a parallel-group design. Participants will be randomly assigned to either an intervention group receiving EIT-guided CPT or a control group receiving only experiential CPT Interventions, lasting 20 minutes each, were administered up to twice daily from ICU admission until discharge. The assessments will occur before interventions, after the 14 days, and after the 28 days. Outcome measures will be collected at before and after the intervention, peak expiratory flow, 30-day weaning success rate, maximum inspiratory pressure, diaphragm thickening rate, diaphragmatic excursion, ICU stay duration, and days from baseline to MV removal or Day 30. Adverse events will be documented. Conclusion This study will evaluate the feasibility and effectiveness of EIT-guided CPT versus conventional CPT in difficult-to-wean patients. If successful, this approach could enhance the efficiency of CPT. Trial registration This study was prospectively registered at the National Library of Medicine (https://clinicaltrials.gov/; reference: NCT06677099; Date of registration: 5th November 2024).https://peerj.com/articles/19727.pdfMechanical ventilationChest physiotherapyElectrical impedance tomographyStudy protocolAirway clearanceIntensive care
spellingShingle Hao Wang
Jianing Xi
Hongying Jiang
Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
PeerJ
Mechanical ventilation
Chest physiotherapy
Electrical impedance tomography
Study protocol
Airway clearance
Intensive care
title Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
title_full Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
title_fullStr Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
title_full_unstemmed Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
title_short Randomized clinical study of electrical impedance tomography-guided chest physiotherapy in difficult-to-wean patients: study protocol
title_sort randomized clinical study of electrical impedance tomography guided chest physiotherapy in difficult to wean patients study protocol
topic Mechanical ventilation
Chest physiotherapy
Electrical impedance tomography
Study protocol
Airway clearance
Intensive care
url https://peerj.com/articles/19727.pdf
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AT jianingxi randomizedclinicalstudyofelectricalimpedancetomographyguidedchestphysiotherapyindifficulttoweanpatientsstudyprotocol
AT hongyingjiang randomizedclinicalstudyofelectricalimpedancetomographyguidedchestphysiotherapyindifficulttoweanpatientsstudyprotocol