The effect of position given to the child after weaning from noninvasive mechanical ventilation on physiological symptoms

Introduction: Respiratory diseases are a common cause of admission to pediatric emergency departments, necessitating admission of some children to pediatric intensive care units. Noninvasive mechanical ventilation is an effective treatment to reduce respiratory effort and improve oxygenation without the use of invasive methods. The position given to the patient during and after noninvasive mechanical ventilation is applied to positively affect tissue oxygenation, prevent pressure sores and prevent infections due to atelectasis. In the literature, there are limited studies examining the effects of prone and supine positions on tissue oxygenation and vital signs. In children with respiratory distress and noninvasive mechanical ventilation treatment and follow-up, there is no standard positioning practice after weaning. Objective: It was planned to examine the effect of the position to be given to children after weaning from noninvasive mechanical ventilation on the physiological symptoms of children. Method: The sample of the randomized controlled comparative study consisted of 40 children aged 6 months-6 years. The children were monitored for 120 minutes after being weaned from xv noninvasive mechanical ventilation with one group prone (n=20) and one group supine (n=20) and their physiologic symptoms were evaluated. Results: No difference was found between the prone and supine position groups in terms of peak heart rate before and after separation. When oxygen saturation was analyzed between the groups, it was observed that the supine position group was significantly higher at 20 and 40 minutes (p<0.05). The respiratory rate of the prone position group children was significantly higher than the supine position group children at 80 minutes (p<0.05). When the difference between 0-40 minutes in systolic blood pressure values after weaning from noninvasive mechanical intubation was examined, it was seen that the prone position group increased more than the supine position group (p<0.05). It was observed that the diastolic blood pressure value of the supine position group children before weaning increased significantly compared to the prone position group children. However, when the diastolic blood pressure values at 120 minutes after separation and before separation were analyzed, it was found that the prone position group children had higher diastolic blood pressure values than the supine position group children (p<0.05). Conclusion: As a result of the study, it was determined that the oxygen saturation was lower at 20 and 40 minutes, the systolic pressure increased more until 40 minutes, the respiratory rate was higher at 80 minutes and the systolic pressure was lower in children who were monitored in the prone position after weaning from noninvasive mechanical ventilation than in children who were monitored in the supine position. The changes in physiologic symptoms according to the positions were not clinically significant. August 2024, 83 pages. Keywords: Noninvasive Mechanical Ventilation, Child, Prone Position, Supine Position, Physiological Symptoms