Convenient ventilation management after pediatric cardiac surgery and the positioning of the
patient helps to reduce the maximum intrathoracic pressure and venous stasis of the trunk and
upper extremities that facilitates the drainage of the blood in the lungs. Due to the fact
that the Pre-operative and post-operative management has tremendously changed for the last
years, more detailed and up-to-date information is required related to the effect of the body
position on the changes of the lung capacities and the pulmonary function. Based on this
reason, this research was designed to determine the effect of three different positions as a
randomized controlled prospective study.
In case the unit does not contain as routine any obstacle for position (unilateral oedema,
ciculation disorder in the extremities, non-bilateral pulmonary atelectasis or dense
infiltration, patients who cannot be administered dormicum or fentaver) right lateral, left
lateral and supine positions are given. First positioning; also in routine, the standart
position given to the first patients is supine position. The patient is first placed supine.
Then his arms and legs are supported with support pillows. Transducer level and cuff pressure
are controlled, SpO2 probe, ECG probes are controlled. If there's CVK connection, if there
isn't any arterial connection, the cuff is controlled and in order to avoid heat loss the
patient is covered after controling the body temperature and the position is completed.
In positioning, the 2nd method is right lateral positioning. In this positioning, the patient
bed is straightened. Later on, the patient's SpO2 probe, ECG probes, CVK, arterial and cuff
connections are once again moved to the right side of the patient and moved from below the
patient's body without contact with the body in order to ensure the connections. Then, the
patient is turned to right side with angle of 60 or 90 degrees and back is supported with a
pillow from the neck to his sacrum, between the legs is also supported with a pillow.
Afterwards, the patient's head is elevated with 45 to 60 degrees. Body temperature is
controlled. The body is covered in order to avoid temperature loss and position is completed.
The third position that is used is left lateral position. In this positioning, the patient
bed is straightened. Then, the patient's SpO2 probe, ECG probe, CVK, artery and cuff
connections are transferred to the left side and the connections are made by passing the
connections from below the pillow of the patient without touching the body. Later on, The
patient is turned to left side with angle of 60 or 90 degrees to the left and the patient's
back is supported with pillow from the neck until the sacrum, between the legs is again
covered with a pillow. After that, the patient's head is elevated with 45-60 degrees. Body
temperature is controlled, covered in order to avoid temperature loss and position is
completed.
In this unit, after performing the applications related to the method used, the patient's
vital signs and SpO2 are checked and recorded every half hour in the postoperative 24 hours,
and hourly in the following processes.
In this study, implementation and data collection for each group will begin after the patient
is admitted to the intensive care unit, after stabilization of the surgery (after the 12th
hour). Until this time, the patient's follow-up is done in supine position. After
stabilization, with the cooperation of the physician, it will continue to be supported by the
right lateral and left lateral positions in addition to the supine position every 2 hours.
Vital signs and SpO2 values of the patient will be recorded just before positioning, at the
1st minute, 1st hour and its 2nd hour after positioning.
