postoperative atelectasis
Conditions
Interventions
experimental group:EIT-visual IS
control grope:Standard incentive spirometer (IS) training
Sponsors
Zhongshan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Aged 18 years or above. 2.Admitted to the Intensive Care Unit (ICU) or postoperative care unit following major thoracic or upper abdominal surgery, having undergone endotracheal extubation, with spontaneous breathing and stable vital signs. 3.Clear consciousness, able to understand and cooperate with training instructions and Electrical Impedance Tomography (EIT) examinations. 4.Morphological screening: Bedside lung ultrasound indicates atelectasis or a significant decrease in lung aeration in the dorsal or posterolateral regions, with complete documentation of the Lung Ultrasound Score (LUS). A standard 12-region or 8-region lung ultrasound scan is performed to record images of the dorsal or posterolateral regions; eligible findings include tissue-like consolidation with or without dynamic air bronchogram, or multiple confluent B-lines suggestive of severe lung aeration reduction. LUS scores for each region are recorded and filed in accordance with the established scoring rules. 5.Functional screening: Baseline EIT under quiet breathing in the semi-recumbent position demonstrates insufficient dorsal ventilation distribution with potential for improvement. The Dorsal Ventilation Fraction (DVF) is calculated using the method of dividing the chest into four equal Regions of Interest (ROI) along the ventral-dorsal axis (DVF = the sum of the percentage of tidal ventilation in ROI 3 and ROI 4). Subjects with a baseline DVF of less than 50% are eligible for enrollment. Baseline DVF is simultaneously used for stratified randomization, with stratification thresholds of <30%, 30% to <40%, and 40% to <50%. 6.Signed written informed consent form; if the subject is temporarily incapable of signing, the form shall be signed by their legal representative in accordance with the ethics committee-approved procedure, and the subject shall provide subsequent informed consent upon recovery of decision-making capacity.
Exclusion criteria
Exclusion criteria: 1.Requiring invasive mechanical ventilation or non-invasive ventilation (NIV), or high-flow nasal cannula (HFNC) oxygen therapy with an inability to maintain stable study conditions. 2.Hemodynamically unstable or unable to tolerate the semi-recumbent position. 3.Unable to cooperate with training or with impaired consciousness. 4.Contraindications to EIT examination, such as incompatibility between an implantable pacemaker/defibrillator and the EIT device, or severe skin lesions or a confirmed history of allergy at the electrode belt contact site. 5.Complicated with severe underlying pulmonary diseases that may significantly affect ventilation distribution and mask the intervention effect. 6.Thoracic deformity or severe scoliosis that impairs the quality of EIT imaging. 7.Body Mass Index (BMI) > 35 kg/m². 8.Pregnant or lactating. 9.Currently participating in other interventional clinical trials that may interfere with the results of this study. 10.Other circumstances deemed ineligible for enrollment by the investigators.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in DVF before and after training (?DVF); | — |
Secondary
| Measure | Time frame |
|---|---|
| Changes in the dependency and silent zones;Intubation Rate During Hospitalization;?SpO2/FiO2;Changes in end-expiratory lung impedance;Mean inspiratory volume; | — |
Countries
China
Contacts
Public ContactLiu Kai
Zhongshan Hospital, Fudan University
Outcome results
None listed