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首页> 外文期刊>Heart and Lung: The Journal of Critical Care >Seated and semi-recumbent positioning of the ventilated intensive care patient - Effect on gas exchange, respiratory mechanics and hemodynamics
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Seated and semi-recumbent positioning of the ventilated intensive care patient - Effect on gas exchange, respiratory mechanics and hemodynamics

机译：坐在和semi-recumbent定位的通风重症监护病人,影响气体交换,呼吸力学和血液动力学

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Objectives: To compare the effect of semi-recumbent and sitting positions on gas exchange, respiratory mechanics and hemodynamics in patients weaning from mechanical ventilation. Background: Upright positions are encouraged during rehabilitation of the critically ill but there effects have not been well described. Methods: A prospective, randomized, cross-over trial was conducted. Subjects were passively mobilized from supine into a seated position (out of bed) and from supine to a semi-recumbent position (45° backrest elevation in bed). Arterial blood gas (PaO2/FiO2, PaO2, SaO2, PaCO2 and A-a gradient), respiratory mechanics (VE, VT, RR, Cdyn, RR/VT) and hemodynamic measurements (HR, MABP) were collected in supine and at 5min and 30min after re-positioning. Results: Thirty-four intubated and ventilated subjects were enrolled. The angle of backrest inclination in sitting (67±5°) was greater than gained with semi-recumbent positioning (50±5°, p0.001). There were no clinically important changes in arterial blood gas, respiratory mechanic or hemodynamic values due to either position. Conclusions: Neither position resulted in significant changes in respiratory and hemodynamic parameters. Both positions can be applied safely in patients being weaned from ventilation.
机译：目的:比较的影响semi-recumbent和坐在位置上气交换,呼吸力学和血液动力学从机械通气患者断奶。背景:直立的位置都是鼓励在危重症的康复效果还没有很好地描述。方法:前瞻性、随机、交叉进行了试验。动员从仰卧位(一个坐着的位置semi-recumbent床)和从仰卧位位置(在45°靠背高度在床上)。动脉血气(PaO2 /供给,PaO2 SaO2, PaCO2和一梯度)、呼吸力学(VE、VT,RR、Cdyn RR / VT)和血流动力学测量(MABP HR)收集在仰卧位和5分钟,重新定位后30分钟。34插管和通风的科目被录取。在坐着(67±5°)大于上涨semi-recumbent定位(50±5°,术中;0.001)。没有临床重要的变化动脉血气、呼吸道技工或血流动力学值由于位置。结论:没有位置了呼吸道和将发生重大变革血流动力学参数。应用安全的病人被断奶通风。

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