Oscillation plus lung-expansion therapy to clear mucus and reopen lungs in ventilated patients with atelectasis

The Efficacy of Oscillation and Lung Expansion (OLE) Therapy Evaluated by Compterized Tomography (CT) and Electrical Impedance Tomography（EIT）in Prolonged Mechanical Ventilated Patients With Atelectasis: A Multicenter Randomized Contralled Trial

This trial tests whether combining chest oscillation with continuous positive airway pressure and high-frequency oscillation can help adults on prolonged mechanical ventilation with atelectasis clear mucus and re-expand their lungs.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Capital Medical University (other)
• Locations: 2 sites (Beijing, Beijing Municipality and 1 other locations)
• Trial ID: NCT07451405 on ClinicalTrials.gov

What this trial studies

The study compares a combined oscillation and lung-expansion (OLE) approach—which integrates CPAP, continuous high-frequency oscillation, and external chest oscillation—against high-frequency chest wall oscillation or other standard airway clearance therapies in hospitalized patients. Eligible patients are adults with prolonged tracheostomy (≥7 days) who have frequent, heavy airway secretions and stable vital signs. Outcomes include secretion clearance, lung re-expansion assessed by imaging and electrical impedance tomography, and changes in respiratory parameters and oxygenation. Safety, tolerance, and short-term clinical respiratory outcomes will be monitored during treatment at the respiratory rehabilitation center.

Who should consider this trial

Good fit: Adults (≥18 years) with prolonged tracheostomy (≥7 days), frequent heavy airway secretions related to pulmonary infection, and stable vital signs are the intended participants.

Not a fit: Patients who are hemodynamically unstable, have untreated pneumothorax, very high oxygen requirements (FiO2 > 60%), recent total pneumonectomy, active hemoptysis, pulmonary bullae, delirium, or who cannot tolerate chest oscillation are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, OLE could speed mucus clearance and reopen collapsed lung areas, potentially shortening time on the ventilator and improving breathing.

How similar studies have performed: High-frequency chest wall oscillation has prior clinical support for improving secretion clearance, but the combined OLE approach (CPAP plus continuous high-frequency oscillation) is a newer, less-tested integrated technique.

Eligibility criteria

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

Where this trial is running

Beijing, Beijing Municipality and 1 other locations

• Respiratory rehabilitation center — Beijing, Beijing Municipality, China (RECRUITING)
• Shuo Chen — Beijing, China (COMPLETED)

Study contacts

• Study coordinator: Shuo Chen

Conditions: Atelectasis, oscillation and lung expansion, high frequency chest wall, electrical impedance tomography