Effect of different position strategies on physiologic hemodynamics parameters among critically Ill patient in ICU: a
Zahra Ahmed Sayed1, Suzie Rababa'h2, Manal Mohamed Abd Elnaeem3
1Critical Care Nursing, Faculty of Nursing, Aswan University, Egypt.
Background:
Body positioning is a standard nursing practice in the intensive care unit (ICU) and it is linked with physiological variations in oxygenation and hemodynamic stability. However, there is a lack of comparative data as to why different positions relate to different parameters that are critical.
Aim:
The aim to assess the changes in key physiological hemodynamic parameters, across different body positions and during transitions between positions in critically ill patients admitted to the ICU.
Methods:
A single group before and after quasi experimental design was used. A total 100 critically ill patients randomly selected from the ICU at King Abdullah University Hospital in Jordan. Each position session lasted two hours, with a 30-minute interval between transitions. Physiological data were collected before and after each session using validated tools.
Results:
Among 100 ICU patients (56% female) a significant change in hemodynamic parameters were observed across positions. Temperature significantly decreased in the supine (p < 0.001) and prone (p = 0.008) positions. Pulse rate decreased significantly in the upright position (p < 0.001). Systolic BP significantly increased in supine and decreased in upright (p < 0.001). Diastolic BP also showed significant changes (p < 0.001). SpO₂ significantly increased in the supine and prone (p < 0.001) positions, while the upright position showed a significant decrease (p < 0.001). Repeated Measures ANOVA confirmed these differences (p < 0.001).
Conclusions:
Body positioning is associated with the changes in hemodynamic and oxygenation parameters in critically ill patients. In particular, prone positioning was associated with an increase in oxygenation, and upright positioning was associated with temporary decreases.
