Head-of-Bed Elevation Improves End-Expiratory Lung Volumes in Mechanically Ventilated Subjects: A Prospective Observational Study.
BACKGROUND: Head-of-bed elevation (HOBE) has been shown to assist in reducing respiratory complications associated with mechanical ventilation; however, there is minimal research describing changes in end-expiratory lung volume. This study aims to investigate changes in end-expiratory lung volume in...
| Publicado en: | Respiratory Care Vol. 59; no. 10; pp. 1583 - 1590 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103899558&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103899558 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2014 vid: 59 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 103899558 98602301 10.4187/respcare.02733 NLM24847096 103899558 ppf: 1583 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Head-of-Bed Elevation Improves End-Expiratory Lung Volumes in Mechanically Ventilated Subjects: A Prospective Observational Study. aug: au: Spooner, Amy J. Corley, Amanda Sharpe, Nicola A. Barnett, Adrian G. Caruana, Lawrence R. Hammond, Naomi E. Fraser, John F. affil: Critical Care Research Group, Adult Intensive Care Services, Prince Charles Hospital and University of Queensland, Chermside, Brisbane, Australia sug: subj: Respiration, Artificial Patient Positioning Methods Supine Position Adverse Effects Lung Volume Measurements Human Prospective Studies Nonexperimental Studies Descriptive Statistics Confidence Intervals Electric Impedance Methods Female Male Middle Age Aged Adult Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Female Male ab: BACKGROUND: Head-of-bed elevation (HOBE) has been shown to assist in reducing respiratory complications associated with mechanical ventilation; however, there is minimal research describing changes in end-expiratory lung volume. This study aims to investigate changes in end-expiratory lung volume in a supine position and 2 levels of HOBE. METHODS: Twenty postoperative cardiac surgery subjects were examined using electrical impedance tomography. End-expiratory lung impedance (EELI) was recorded as a surrogate measurement of end-expiratory lung volume in a supine position and at 20° and then 30°. RESULTS: Significant increases in end-expiratory lung volume were seen at both 20° and 30° HOBE in all lung regions, except the anterior, with the largest changes from baseline (supine) seen at 30°. From baseline to 30° HOBE, global EELI increased by 1,327 impedance units (95% CI 1,080-1,573, P < .001). EELI increased by 1,007 units (95% CI 880-1,134, P < .001) in the left lung region and by 320 impedance units (95% CI 188-451, P < .001) in the right lung. Posterior increases of 1,544 impedance units (95% CI 1,405-1,682, P < .001) were also seen. EELI decreased anteriorly, with the largest decreases occurring at 30° (−3 3 5 impedance units, 95% CI −486 to −183, P < .001). CONCLUSIONS: HOBE significantly increases global and regional end-expiratory lung volume; therefore, unless contraindicated, all mechanically ventilated patients should be positioned with HOBE. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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