Effect of Patient Position on Respiratory System in Adult and Pediatric Intensive Care Units

Abstract

Physiotherapy applications are frequently used in intensive care units in order to minimize risk of complications and negative effects of immobilization, invasive treatments such as mechanical ventilation treatment. One basic component of these applications is positioning, which is based on changing body position according to gravity. Primary goal of positioning applications in immobile and critically ill patients is to maintain and improve oxygen delivery and tissue oxygenation. With positioning, improvements in respiratory system physiology and mechanics are aimed with increased ventilation and oxygenation, compatible ventilation/perfusion, prevention of atelectasis and prevention of ventilatoryassociated pneumonia. Fot these reasons, supine, prone, high supine lying to certain degrees, lateral positioning and continuous lateral rotation treatment can be applied in intensive care units. The risk of complications can be minimized and respiratory activities can be improved with positioning which is suitable for patient and the disease

Keywords

• Intensive care
• neonatal
• positioning
• pulmonary function
• pediatrics

Yetişkin ve Pediatrik Yoğun Bakım Ünitelerinde Hasta Pozisyonlamanın Solunum Sistemine Etkisi

Abstract

Yoğun bakım ünitelerinde immobilizasyonun olumsuz etkilerini ve mekanik ventilasyon tedavisine bağlı komplikasyonları minimuma indirmek amacıyla fizyoterapi uygulamalarından sıklıkla faydalanılmaktadır. Bu uygulamaların bir ana bileşeni ise vücut pozisyonunun graviteye göre değiştirilmesi temeline dayanan pozisyonlama tedavisidir. İmmobil ve kritik durumdaki hastalarda pozisyonlama uygulamalarının birincil hedefi, oksijen iletimini ve doku oksijenasyonunu korumak ve iyileştirmektir. Pozisyonlama uygulamalarıyla amaçlanan diğer etkiler ventilasyonda artış, uyumlu ventilasyon/perfüzyon oranı, atelektazinin önlenmesi ve ventilatör ilişkili pnömoninin önlenmesidir. Böylece solunum sistemi fizyolojisi ve mekaniğinde iyileşmeler meydana gelecektir. Bu doğrultuda sırtüstü, yüzüstü, belirli derecelerde yüksek sırtüstü yatış, lateral pozisyonlama ve sürekli lateral rotasyon tedavisi yoğun bakım ünitelerinde uygulanabilmektedir. Hastaya ve hastalığa uygun pozisyonlama uygulamalarıyla komplikasyon riski en aza indirilebilir ve solunumsal faaliyetler iyileştirilebilir.

Keywords

• Pediatri
• yenidoğan
• pozisyonlama
• pulmoner fonksiyon
• yoğun bakım.

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