The Effect of Body Positioning on Physiologic Index in Patients with Unilateral Lung Disease

Cho, Jee Yeon; Lee, Hyang Yeon

Abstract

The purpose of this study was to identify the effect of body positioning on PaO2, SpO2, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of PaO2 value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: 1. PaO2 2. SpO2 3. systolic blood pressure 4. diastolic blood pressure 5. pulse. The results obtained were as follows: 1. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the PaO2 value in the semi-Fowler's position and the PaO2 value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.