This study aims to evaluate the effect of ventilator hyperinflation combined with body positioning on arterial blood gases in patients with ventilator-associated pneumonia. Forty-two mechanically ventilated patients will be randomly assigned into two groups receiving the intervention in either supine or lateral decubitus positions. Arterial blood gases will be assessed over a 6-day intervention period. The findings are expected to provide evidence regarding the optimal positioning strategy to enhance the effectiveness of ventilator hyperinflation in improving gas exchange in critically ill patients.
Mechanically ventilated patients ≥ 48 hours
Diagnosed with VAP (clinical + chest X-ray)
Age: 40-60 years
Hemodynamically stable
Bilateral lung disease
Unstable cardiovascular conditions
Contraindications to positioning
Re-intubation cases
Parallel
Ventilator hyperinflation
Devicea therapeutic technique used by clinicians (Manual or Ventilator Hyperinflation) to clear secretions and recruit collapsed lung tissue, or an inadvertent complic
Manual hyperinflation
Devicea respiratory therapy technique that uses a manual resuscitation bag to deliver larger-than-normal, controlled breaths to clear airway secretions and reopen collapsed lung areas
PaCO2
partial pressure of carbon dioxide in arterial blood, measuring how effectively the lungs eliminate carbon dioxide
PaO2
partial pressure of oxygen dissolved in arterial blood plasma, measured through an Arterial Blood Gas (ABG) test.
SaO2
the percentage of oxygen-saturated hemoglobin relative to total hemoglobin in arterial blood, typically measured via an invasive arterial blood gas (ABG) analysis with normal values ranging from 95% to 99%
PaO2/FiO2 (P/F)
a clinical metric used to evaluate oxygenation efficiency and diagnose the severity of acute hypoxemic respiratory failure or Acute Respiratory Distress Syndrome (ARDS).
Pulmonary compliance
the change in lung volume divided by the change in pressure (Δ V / Δ P). Higher compliance means the lungs stretch easily; lower compliance means they are stiff and harder to inflate
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