Effect of Positioning on Oxygenation and Hemodynamics among Patients on Mechanical Ventilation
Abstract
Context: The routine practice of positioning is a vital procedure in critical care units, especially when prophylaxis is the aim. For many years, nurses have recognized that positioning prevents skin breakdown, mobilizes secretions, and provides comfort without identifying the impact of different positioning strategies on pulmonary gas exchange and ventilator weaning outcomes.
Aim: The current study was conducted to assess the effect of positioning on oxygenation and hemodynamics among patients on mechanical ventilation.
Methods: This study was conducted in the medical intensive care unit at El-Demerdash hospital, affiliated to Ain-Shams University. A descriptive exploratory study design was utilized in this study. A purposive sample of 93 patients was recruited in the present study. A structured interview questionnaire and patient assessment record were employed to collect data related to this study.
Results: The results reveal that 39.8% of the studied patients’ age was between 45-<65, 30.1% had chronic obstructive pulmonary disease. Oxygenation significantly decreases in the supine position at p 0.003 and increases in the semi-recumbent position at p 0.020. Heart rate is significantly increased in semi-recumbent position at p<0.005. Systolic and diastolic blood pressure significantly decreased in semi-recumbent positions at p<0.010 and p=0.021, respectively, at T30, T60, and T120.
Conclusion: Regarding oxygenation and hemodynamics, the results of this study concluded that the best oxygenation was in semi-recumbent position T120. Regarding hemodynamics, heart rate is significantly increased in the left lateral and semi-recumbent positions. Systolic and diastolic blood pressure were significantly affected by positioning. The time of changing position should be reviewed to be compatible with the most effective position for mechanically ventilated patients considering the patient oxygenation and hemodynamic states.
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