THE EFFECTS OF DIFFERENT POSITIONS ON PHYSIOLOGICAL MEASUREMENT AND PERFUSION INDEX IN PEDIATRIC INTUBATED PATIENTS

Abstract

The aim of this study is to determine the effects of four different body positions applied to paediatric intubated patients on physiological variables and perfusion index.The sample of this study, which was conducted as a quasi-experimental study in a single group in a paediatric intensive care unit, consisted of 44 intubated and monitored patients. The patients were given supine, right-lateral, left-lateral and Semi Fowler positions at intervals of two hours, and each position’s measurements were evaluated separately. In the analysis of data, number, percentage, mean, standard deviation, ANOVA, and post-hoc (Tukey HSD) tests were used. Fifty per cent of the patients were under 1 year old, 56.8% were male, and the mean patient age was 20.61±21.72 months. Peripheral oxygen saturation, systolic blood pressure and perfusion index mean values in the supine and Semi Fowler positions given to the patient were found to be statistically significant (p<0.05). It was determined that SPO2, systolic blood pressure and perfusion index values were higher in the semi-fawler position than in the other positions.

Keywords

• position
• paediatric intensive care
• physiological parameter
• perfusion index

References

1. Kiliç, F. Z., Çoban, Y., Davutoglu, M., & Dalkiran, T., "A retrospective analysis of patients monitored in a pediatric intensive care unit and an investigation of factors affecting mortality", Cocuk Acil ve Yogun Bakım, 3(3), 140-145, 2016.
2. Bargos-Munárriz, M., Bermúdez-Pérez, M., Martínez-Alonso, A. M., García-Molina, P., & Orts-Cortés, M. I.,"Prevention of pressure injuries in critically ill children: A preliminary evaluation", Journal of Tissue Viability, 29(4), 310-318, 2020.
3. Wieczorek, B., Ascenzi, J., Kim, Y., Lenker, H., Potter, C., Shata, N. J., ... & Kudchadkar, S. R., "PICU Up!: Impact of a quality improvement intervention to promote early mobilization in critically ill children", Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 17(12), e559, 2016.
4. Anchala, A. M.,"A study to assess the effect of therapeutic positions on hemodynamic parameters among critically ill patients in the intensive care unit at Sri Ramachandra Medical Centre," Journal of Nurse Care, 5(3), 2-8, 2016.
5. Thomas, P. J., Paratz, J. D., Lipman, J., & Stanton, W. R.,"Lateral positioning of ventilated intensive care patients: a study of oxygenation, respiratory mechanics, hemodynamics, and adverse events", Heart & Lung, 36(4), 277-286, 2007.
6. Jocelyn Chew, H. S., Thiara, E., Lopez, V., & Shorey, S., "Turning frequency in adult bedridden patients to prevent hospital‐acquired pressure ulcer: A scoping review," International Wound Journal, 15(2), 225-236, 2018.
7. Ateş, İ., Erden, A., Gürler, E. K., Çağlayan, A., Güçbey, Ö., Karakaş, Ö., ... & Omma, A., "Compliance to not only prone but also lateral and supine positioning improves outcome in hospitalised COVID‐19 patients", International Journal of Clinical Practice, 75(11), e14673, 2021.
8. Agustina, N., Nurhaeni, N., & Hayati, H.,"Right lateral position can improving oxygen saturation and respiratory rate on under-five children with pneumonia", La Pediatria Medica e Chirurgica, 43, 262, 2021.

9. Piva, T. C., Ferrari, R. S., & Schaan, C. W.,"Early mobilization protocols for critically ill pediatric patients: systematic review", Revista Brasileira de terapia intensiva, 31, 248-257, 2019.
10. Hasanin, A., Mohamed, S. A. R., & El-Adawy, A., "Evaluation of perfusion index as a tool for pain assessment in critically ill patients", Journal of Clinical Monitoring and Computing, 31(5), 961-965, 2017.
11. Emerson R. J.and J. L. Banasik., "Effect of position on selected hemodynamic parameters in postoperative cardiac surgery patients", American Journal of Critical Care, 3(4), 289-299, 1994.
12. Thijssen, M., Janssen, L., Le Noble, J., & Foudraine, N.,"Facing SpO2 and SaO2 discrepancies in ICU patients: is the perfusion index helpful?” Journal of Clinical Monitoring and Computing, 34(4), 693-698, 2020.
13. [Özden, T. O. R., Gülçay, M. E. R. T., & Tosun, B., "Yoğun bakım hastalarına verilen pozisyonların hemodinamik ölçümlere etkisi," Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi,12(1), 15-20, 2019.
14. Göcze, I., Strenge, F., Zeman, F., Creutzenberg, M., Graf, B. M., Schlitt, H. J., & Bein, T.,"The effects of the semirecumbent position on hemodynamic status in patients on invasive mechanical ventilation: prospective randomized multivariable analysis”, Critical care, 17(2), 1-9, 2013.
15. Tod Brindle, C., Malhotra,R., O’rourke, S., Currie, L., Chadwik, D., Falls, P., Adams, C., Swensonn, J., Tuason, D., Watson, S., Creehan, S., “Turning and repositioning the critically ill patient with hemodynamic instability: A literature review and consensus recommendations”, Journal of Wound, Ostomy and Continence Nursing, 40(3), 254–267, 2013. https://doi.org/10.1097/WON.0B013E318290448F
16. Tapar, H., Karaman, S., Dogru, S., Karaman, T., Sahin, A., Tapar, G. G., & Suren, M., “The effect of patient positions on perfusion index”, BMC anesthesiology, 18(1), 1-4, 2018.