Premium
The effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients: A randomised controlled trial
Author(s) -
Hassan Eman Arafa,
Baraka Azza Abd Elrazek
Publication year - 2021
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.15645
Subject(s) - medicine , trendelenburg , trendelenburg position , anesthesia , ventilation (architecture) , critically ill , mechanical ventilation , intensive care medicine , mechanical engineering , engineering
Abstract Aims and objectives To investigate the effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients. Background Reverse Trendelenburg position is recommended for obese patients; however, the effect among critically ill patients, especially those on mechanical ventilation, has limited study. Design Randomised, controlled pretest, repeated post‐test trial with two parallel groups. Methods The study started from 13 January 2020–12 March 2020. Adult critically ill patients with a body mass index ≥30 were randomly assigned by computer‐generated randomisation to either reverse Trendelenburg position group (intervention) or semi‐recumbent position group (active comparator control). Outcome measures were ventilation parameters (dynamic compliance, partial pressure of arterial carbon dioxide and minute volume) and oxygenation parameters (hypoxaemic index and partial pressure of arterial oxygen). Measures were assessed immediately before positioning and after positioning in 10 minutes, 20 minutes and 30 minutes. CONSORT checklist was used to report the current study. Settings Four general intensive care units. Results One hundred and ten patients (55 patients in each group) completed the study. The reverse Trendelenburg position group had a higher improvement than the semi‐recumbent position group as estimated by mean differences in their dynamic compliance, minute volume, partial pressure of carbon dioxide, partial pressure of oxygen and hypoxaemic index. Conclusion Reverse Trendelenburg position improves obese patients’ respiratory parameters more than semi‐recumbent position. Relevance to clinical practice This study directs nurses to use the reverse Trendelenburg position, which is an important position for enhancing the parameters of ventilation and oxygenation of obese mechanically ventilated patients.