Effect of Infection-Site-Targeted Postural Drainage on Mechanical Ventilation Duration in Intensive Care Unit Patients: A Randomized Controlled Trial

Background: Mechanical ventilation (MV) is essential for intensive care unit (ICU) patients with respiratory failure, but prolonged MV increases the risk of complications. Purpose: This study was conducted to evaluate the effect of infection-site-targeted postural drainage, guided by imaging, on patient outcomes compared with conventional care. Methods: In this randomized controlled trial, 384 ICU patients requiring MV were assigned to either the personalized-care group (PCG), which received imaging-guided drainage, or the routine-care group (RCG), which received standard positional changes. The primary outcome was MV duration, and secondary outcomes included PaO 2 /FiO 2 (PF) ratios, ICU/hospital length of stay, and 28-day mortality. Results: The PCG was found to have significantly shorter MV duration (median 7 vs. 9 days, p <.05) and higher PF ratios at critical time points (X2, X4, X5; p <.001). A shorter average ICU stay length was reported for the PCG (12.3 vs. 13.4 days), although the difference was not significant after multivariable adjustment. No between-group difference was observed in terms of 28-day mortality. Conclusions: The results indicate that imaging-guided, nursing-led postural drainage effectively improves pulmonary function and shortens MV and ICU lengths of stay without increasing mortality risk, supporting the integration of individualized pulmonary care, potentially enhanced through intelligent technologies, into routine ICU practice.