Prone position ventilation (PPV) is an important lungprotective therapeutic measure for patients with respiratory failure in the intensive care unit (ICU). When conventional auxiliary cushions are used for prone position ventilation in clinical practice, complications such as impaired circulatory status caused by compression of the chest and abdomen, pressure injuries to the skin, displacement or dislodgement of pipelines, vomiting and aspiration tend to occur. Meanwhile, traditional manual back percussion for sputum clearance has limited efficiency, which compromises the safety and clinical efficacy of prone position ventilation therapy. To investigate the effects of the multiangle PPV auxiliary device combined with a vibration sputum expectoration instrument on hemodynamics, arterial blood gas parameters and related complications in ICU patients with respiratory failure, so as to provide clinical reference for the standardized and safe implementation of prone position ventilation for such patients.

Fifty-one patients with respiratory failure admitted to our hospital from October 2024 to February 2026 were selected and randomly divided into a control group (26 cases) and an observation group (25 cases). The control group received an auxiliary cushion combined with manual back percussion for sputum expectoration, while the observation group received multi-angle PPV combined with a vibration sputum expectoration instrument for postural drainage management. Central venous pressure (CVP), cardiac output (CO), stroke volume variation (SVV), and cardiac index (CI); arterial oxygen saturation (SaO₂), partial pressure of oxygen in arterial blood (PaO₂), oxygenation index (PaO₂/FiO₂), and the incidence of complications were compared between the two groups.

At 6 h of prone position ventilation, the hemodynamic parameters in the observation group, including CO[(4.11 ± 0.62) L/min vs. (3.42±0.95)L/min], SVV[(9.55±2.25)% vs. (11.11±2.08)%], and CI[(3.47±0.27)L/(min·m²) vs. (3.03±0.26)L/(min·m²)], were superior to those in the control group (P<0.05). On day 3, there were no statistically significant differences in SaO₂, PaO₂, or PaO₂/FiO₂ between the observation group and the control group (P>0.05). On day 7, SaO₂[(92.39±2.10)% vs. (90.93±1.93)%], PaO₂[(90.12±1.93) mmHg vs. (88.59±2.75)mmHg], and PaO₂/FiO₂[(364.07±21.02) vs. (351.77±17.92)] in the observation group were higher than those in the control group (P<0.05). The observation group had lower incidences of pressure skin injury (1 case vs. 5 cases), tube dislodgement (0 cases vs. 3 cases), vomiting (1 case vs. 4 cases), and aspiration (0 cases vs. 4 cases) than the control group. The single sputum suctioning operation time in the observation group [(56.76±8.22)s vs. (86.16±7.65)s] was shorter than that in the control group (P<0.05). In the observation group, 18 patients survived (72.00%) and 7 died (28.00%); in the control group, 18 patients survived (69.23%) and 8 died (30.77%).

The multi-angle prone position assistive device combined with a vibration sputum expectoration instrument can improve hemodynamic and arterial blood gas parameters, the incidence of related complications, shorten sputum suctioning time of ICU patients with respiratory failure.