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Pulmonary-Focused Verticalization Therapy in Patients Experiencing Respiratory Failure
Heather Fudala1, Shelly Orr2, Elisa Winn3
1Heather Fudala is nursing research program director, Virginia Commonwealth University Health System, Richmond, Virginia.
Summary
Verticalization therapy, a method for upright patient positioning, showed potential benefits but faced challenges with patient safety and nursing staff availability in a small intensive care unit study.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Patient Safety
Background:
- Mechanical ventilation and prone positioning pose risks like infection and injury.
- Verticalization therapy involves controlled, in-bed upright positioning.
- Prior studies suggest verticalization may improve oxygenation in respiratory failure.
Purpose of the Study:
- To assess the safety and feasibility of verticalization therapy.
- To evaluate its use in patients with respiratory distress, including COVID-19 patients.
Main Methods:
- Adult patients in a medical respiratory intensive care unit participated.
- Up to two daily sessions of verticalization therapy were administered.
- Session duration aimed for 30 to 120 minutes.
Main Results:
- Recruitment halted after 6 of 15 planned participants due to safety concerns (hypotension, desaturation) and staffing shortages.
- Most participants tolerated the therapy, but one session was stopped early due to adverse events.
- Inadequate nursing staff hindered consistent therapy delivery.
Conclusions:
- Limited participant numbers restrict definitive conclusions.
- Future research should account for patient severity and use a slower verticalization rate.
- Verticalization therapy increased nursing workload despite unclear benefits for other healthcare providers.
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