The effect of protective lying position's on hemodynamic parameters in patients with mechanically ventilated and spontaneous breathing

Aim: The study was carried out to examine the effect of protective lying positions on hemodynamic parameters in patients with mechanical ventilation (MV) and spontaneous breathing. Material and Methods: The research was carried out semi-experimentally with a single-group posttest design, between the dates of 15.11.2021 and 15.05.2022 in the Internal Medicine Intensive Care (ICU) Unit of Aydın Adnan Menderes University Hospital. The study of the sample consisted of MV dependent (n=30) and spontaneously breathing (n=30) patients in the ICU. Data were collected with the patient identification form and the hemodynamic parameters follow-up form. Right lateral, semi Fowler's, left lateral and supine positions were applied to the patients every 2 hours between 9 am 5 pm for 3 days and then pulse rate, respiratory rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and oxygen saturation (SpO₂) were measured at 10th minute, 1st hour and 2nd hour. In data analysis, number, arithmetic mean, standard deviation, chi-square, independent groups t test and one-way ANOVA test were used. Results: In our study, the mean age of the patients due to MV was 69.33±9.50 years, 56.7% of them were male and most of them (60%) were hypertensive. The mean age of the patients with spontaneous breathing was 70.03±14.75 years, 53.3% of them were women and most of them (46.7%) were hypertensive. There wasn't found statistically significant difference between the mean pulse rates of both MV-induced and spontaneously breathing patients at different times of position changes (p>0.05). While it was determined that the mean SBP measured at the 1st hour of the right lateral position on the 2nd day in spontaneously breathing patients decreased statistically significantly compared to the mean SBP in other positions (p<0.05), there was no statistically significant difference between the mean SBP in different positions of the patients due to MV (p>0.05). While it was determined that the DBP average measured at the 1st hour of the semi Fowler's position on the 2nd day in spontaneously breathing patients increased statistically significantly compared to the DBP averages in the other positions (p<0.05), there was no statistically significant difference between the DBP averages of the patients with MV in different positions. (p>0.05). While it was found that the mean respiratory rate measured at the 1st hour of the semi Fowler's position on the 3rd day in spontaneously breathing patients increased statistically significantly compared to the mean respiratory rate in other positions (p<0.05), there was a statistically significant difference between the mean respiratory rate in different positions of the patients due to MV no difference was detected (p>0.05). While it was determined that the average of SpO₂ measured at the 10th minute of the right lateral position on the 3rd day in patients with MV was statistically significantly higher than the values in other positions (p<0.05), SpO₂ averages did not statistically change in different positions of the spontaneous respiratory patients (p>0.05). Conclusion: It was concluded that the positions applied to the patients did not change the pulse rate, SBP changed in the right lateral position in spontaneously breathing patients, DBP and respiratory rate changed in the semi Fowler's position, SpO₂ value changed in the right lateral position in patients with MV, but these changes did not show continuity.