Hemodynamic changes with manual and automated lateral turning in patients receiving mechanical ventilation

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
Shannan HamlinRobert F Lodato

Abstract

Lateral turning of critical care patients receiving mechanical ventilation can adversely affect hemodynamic status. To study hemodynamic responses to lateral turning. A time-series design with automated signal processing and ensemble averaging was used to evaluate changes in heart rate, mean arterial pressure, and pulse pressure due to lateral turning in 13 adult medical-surgical critical care patients receiving mechanical ventilation. Patients were randomly assigned to the manual-turn or the automated-turn protocol for up to 7 consecutive days. Heart rate and arterial pressure were measured every 6 seconds for more than 24 hours, and pulse pressure was computed. A total of 6 manual-turn patients and 7 automated-turn patients completed the study. Statistically significant changes in heart rate, mean arterial pressure, and pulse pressure occurred with the manual turn. Return of the hemodynamic variables to baseline values required up to 45 minutes in the manual-turn patients (expected recovery time ≤ 5 minutes). However, clinically important changes dissipated within 15 minutes of the lateral turn. The steady-state heart rate response on the right side was slightly greater (3 beats per minute) than that on the back (P = .003). A...Continue Reading

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Citations

Mar 20, 2016·Heart & Lung : the Journal of Critical Care·Robert AndersonMiriam Zimmerman

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