A Randomized Controlled Trial of Incomplete Prone Position Versus Lateral Position in Non-Mechanically Ventilated Adults With a Tracheostomy.

This study aimed to explore the effects of the incomplete prone position in non-mechanically ventilated adults with a tracheostomy, providing evidence for its clinical management. Non-mechanically ventilated adults (n = 64) with a tracheostomy who met the inclusion and exclusion criteria were included in this randomized controlled trial. They were randomly assigned to either a control group (n = 32) and or an experimental group (n = 32). Both groups received standard tracheostomy care. The experimental group was positioned in the incomplete prone position, while the control group was maintained in the lateral position. Continuous intervention lasted for 7 days. We compared the differences in respiratory oxygenation indicators, pulmonary infection rates, sputum volume, hemodynamics, and the complications between the two groups. After 7 days of intervention, the experimental group demonstrated significantly higher arterial partial pressure of oxygen and oxygenation index than the control group (p < .05). From day 2 onward, pulse oxygen saturation was consistently higher in the experimental group compared to the control group (p < .001). Furthermore, a significantly lower respiratory rate was observed in the experimental group from day 4 onward (p < .001). No statistically significant difference was found in the incidence of pulmonary infection between the two groups (p > .05). However, a significant intergroup difference was observed in the Clinical Pulmonary Infection Score (p < .05). From day 1 to 7, the experimental group exhibited significantly higher daily sputum volume than the control group (p < .001). The analysis of sputum volume revealed significant effects for both time and group (p < .001), but the group-by-time interaction effect was not statistically significant (p = .064). No significant effects for time or group were found on hemodynamic parameters, including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure (p > .05). Additionally, the group-by-time interaction effect was not statistically significant (p > .05). Importantly, no severe complications occurred in either group. The incomplete prone position significantly improved oxygenation, promoted airway secretion clearance, and reduced pulmonary infection severity in non-mechanically ventilated adults with a tracheostomy.