Effects of position changes on oxygenation and comfort level in patients undergoing off-pump coronary artery bypass surgery before and after their weaning from mechanical ventilator
Date Issued
2004
Date
2004
Author(s)
Sheng, Shu-Mei
DOI
zh-TW
Abstract
Position-change is an important clinical nursing procedure. Position-change in post-cardiac surgical patients can affect their oxygenation function and comfort level, and has a big influence on post-operative recovery. Up to now, there are few studies of influence of position-change on the patients’ oxygenation function and comfort levels before and after their weaning from the ventilator. This study is to investigate the influence of position-change (head of bed elevated to 0∘,30∘, 60∘) on oxygenation function and comfort level of off-pump coronary artery bypass graft patients before and after their weaning from ventilator. This is a quasi-experimental study. Thirty patients, who underwent off-pump coronary artery bypass grafting in a medical center during the period from October 2003 to March 2004, were prospectively collected for this study. Within 2 hours after their admission to intensive care unit for postoperative care, we did “before the weaning” study, and during the period between 2 hours and 16 hours after the extubation, we did “after the weaning” study. The study investigated the influence of position-change (head of bed elevated to 0∘,30∘, 60∘) on different aspects of oxygenation, including pulse oxymetry (SpO2), arterial blood oxygen tension (PaO2), respiratory rate (RR), heart rate (HR), systolic arterial blood pressure (SABP), diastolic arterial blood pressure (DABP), mean arterial blood pressure (MABP), and mixed venous blood oxygen saturation (SvO2). We also evaluated the patients’ comfort levels by visual analog scale (VAS) and happy-face-sad-face scale. The study revealed significant change of respiratory rate at different degrees of bed-head elevation before the ventilator weaning. Respiratory rates were significantly higher when the patients’ bed-heads were elevated to 60∘compared to 0∘. Systolic arterial blood pressure had significant difference among different degrees of bed-head elevation, however, Sheff’s method found no statistical difference between each pair of bed-head elevation degrees. After the ventilator weaning, position-change did not significantly influence oxygenation function. No matter before or after the ventilator weaning, comfort levels evaluated by VAS by the patients themselves or by happy-face-sad–face scales by nursing staff, showed significant difference at different degree of bed-head elevation. Comfort levels at bed-head elevation at 60∘were worse than those at 0∘or 30∘, but there is no difference between 0
Subjects
舒適程度
氧合功能
無體外循環冠狀動脈繞道手術
姿勢改變
Oxygenation
Off-pump coronary artery bypass surgery
Comfort level
Position change
Type
other
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