Seated and semi-recumbent positioning of the ventilated intensive care patient - effect on gas exchange, respiratory mechanics and hemodynamics

Thomas, Peter, Paratz, Jennifer and Lipman, Jeffrey (2014) Seated and semi-recumbent positioning of the ventilated intensive care patient - effect on gas exchange, respiratory mechanics and hemodynamics. Heart and Lung: Journal of Acute and Critical Care, 43 2: 105-111. doi:10.1016/j.hrtlng.2013.11.011


Author Thomas, Peter
Paratz, Jennifer
Lipman, Jeffrey
Title Seated and semi-recumbent positioning of the ventilated intensive care patient - effect on gas exchange, respiratory mechanics and hemodynamics
Journal name Heart and Lung: Journal of Acute and Critical Care   Check publisher's open access policy
ISSN 0147-9563
1527-3288
Publication date 2014-03
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.hrtlng.2013.11.011
Open Access Status
Volume 43
Issue 2
Start page 105
End page 111
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Mosby
Collection year 2015
Formatted abstract
Objectives: To compare the effect of semi-recumbent and sitting positions on gas exchange, respiratory mechanics and hemodynamics in patients weaning from mechanical ventilation.
Background: Upright positions are encouraged during rehabilitation of the critically ill but there effects have not been well described.
Methods: A prospective, randomized, cross-over trial was conducted. Subjects were passively mobilized from supine into a seated position (out of bed) and from supine to a semi-recumbent position (>45° backrest elevation in bed). Arterial blood gas (PaO2/FiO2, PaO2, SaO2, PaCO2 and A-a gradient), respiratory mechanics (VE, VT, RR, Cdyn, RR/VT) and hemodynamic measurements (HR, MABP) were collected in supine and at 5min and 30min after re-positioning.
Results: Thirty-four intubated and ventilated subjects were enrolled. The angle of backrest inclination in sitting (67±5°) was greater than gained with semi-recumbent positioning (50±5°, p<0.001). There were no clinically important changes in arterial blood gas, respiratory mechanic or hemodynamic values due to either position.
Conclusions: Neither position resulted in significant changes in respiratory and hemodynamic parameters. Both positions can be applied safely in patients being weaned from ventilation.
Keyword Intensive care
Posture
Respiratory mechanics
Semi-recumbent
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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