The goal of this quasi-experimental study is to investigate how different body positions, performed through Automatic Lateralization Therapy, affect respiratory drive, ventilation, and pulmonary aeration in critically ill adult patients under mechanical ventilation. The main questions this study aims to answer are:
* Does Automatic Lateralization Therapy, modify respiratory drive, as measured by P0.1, estimated Pmus, and sEMG of the diaphragm and parasternal muscles? * Is there an association between respiratory drive, ventilation, and pulmonary aeration measured by Electrical Impedance Tomography (EIT) in different body positions promoted by Automatic Lateralization Therapy ?
Does combining Automatic Lateralization Therapy, with Flow Bias improve physiological and functional outcomes compared to Automatic Lateralization Therapy, without Flow Bias?
Participants will:
* Be positioned in different lateralization strategies using Automatic Lateralization Therapy, while under mechanical ventilation; * Have respiratory parameters and ventilation images assessed by EIT and sEMG;
Participate only during their ICU stay, with no need for additional visits after discharge.
Patients of both sexes will be included;
Aged ≥ 18 years;
BMI 18-35 kg/m²;
Under invasive mechanical ventilation via orotracheal tube for ≥ 24 hours and expected to remain on mechanical ventilatory support for at least 48 hours;
Patients presenting medical restrictions to body repositioning, or to the use of EIT or sEMG;
Those in therapeutic failure;
Individuals with spinal cord injury, brain injury, or stroke with a history of functional loss and respiratory impairment prior to hospitalization;
Neurological diseases affecting respiratory myoelectric conduction;
University of Pernambuco
Lead sponsor
Universidade Federal de Pernambuco
Collaborator
Fundação de Amparo à Ciência e Tecnologia de Pernambuco
Collaborator
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Collaborator