Improvement Of Patient’s Ventilation By Correcting The Slid Recumbent Position In The ICU

Until today the proper positioning of the patient in bed was restricted in the elevation of the back of his bed. The fact of the patient’s sliding requires to count in the newly acquired posture in bed while evaluating the respiratory capacity. There is a statistical correlation (r= 0.656) in the mean PO2, (partial oxygen pressure), improvement (ΔPO2= 16.15 +/4.8 mmHg) when the repositioning is greater than 14 cm. In case that the sliding is smaller, the overall effect on patient’s respiration is negligible. On the contrary if there is overcorrection with the coccyx over the hinge of the bed, there is a negative result in PO2 (ΔPO2= -10.3 +/4.32 mmHg), extremely crucial for the patients of the Intensive Care Unit (ICU). LNTRODUCTION The correct positioning of the patient in bed is essential during the whole period of his hospitalization. Regarding the rehabilitation of the respiratory system, the acquisition of proper position will help in the removal of the bronchial secretion, in the good functioning of the diaphragm and in better pulmonary aeration. In the past decades the medical literature has established some undeniable rules 2, . In order that the patient in the ICU avoids the intubation or recover his own breathing capacity (after being on mechanical respiration), he has to maximize his tidal volume. According to the current bibliography the patient must be placed in supine position with the upper part of the body at 30 – 45 for optimal ventilation . In current bibliography the missing element is the determination of the distance between patient’s coccyx and the hinge of the bed that will permit full expansion of the thoracic cavity. The purpose of this study is to calculate this distance in the patients of the ICU. MATERIAL AND METHODS All patients who composed the study sample were ICU patients of “Attikon” University Hospital in Athens. ELIGIBILITY CRITERIA Their identification was based on their primary bed position. The distance between the hinge of the bed and patient’s greater trochanter was obviously big. They had their own breathing capacity while they were supported by a mixture of air with 35 to 45% O2. They had been stable without receiving any medical treatment for their respiratory system for the last 3 hours before the measurements. Blood PO2 was collected from the radial artery and verified by a second measurement after 15 min. A Premium type 3000 analyzer was used. EXCLUSION CRITERIA In case that the measurements differed more than 5% between the first measurement and the second, the patient was considered respiratory instable and was excluded from the study. After repositioning the patient and a lapse of 15min we repeated the procedure of blood collection-analysis. The following parameters were studied: α PO2, α S α* PO2 β ΡO2, β S α = measurements while in the slid position α*= verification of measurements while in the slid position β = measurements in the corrected position Improvement Of Patient’s Ventilation By Correcting The Slid Recumbent Position In The ICU