Effects of different postures on tidal volume changes in patients with chronic pulmonary heart disease under mechanical ventilation
ZHONG Dong-ying1 LIANG Qian2 HUANG Cai-yun2
1.Department of Nursing,Yangdong People′s Hospital in Yangjiang City,Guangdong Province,Yangjiang 529900,China;2.Intensive Care Unit,Yangdong People′s Hospital in Yangjiang City,Guangdong Province,Yangjiang 529900,China
Abstract：Objective To explore the effect of different body positions on the change of moisture content under mechanical ventilation in patients with chronic pulmonary heart disease,and to provide a basis for the formulation of mechanical ventilation for such patients.Methods 50 cases of chronic pulmonary heart disease in our hospital from June 2013 to June 2015 were selected as the case group.At the same time,50 patients in the department of digestive medicine,department of orthopedics and ophthalmology at the same time were selected as the healthy control group.Each group was randomly divided into supine group and lateral decubitus group.The tidal volume,lung function,blood gas analysis and hospitalization were analyzed and compared under different body positions.Results In patients with chronic pulmonary heart disease,the volume of tidal gas under mechanical ventilation was lesser than that of the control group,while the peak volume ratio and the peak time ratio were lesser than those of the normal people.In addition,the tidal volume of the lateral position was lesser than that in the supine position,but the ratio of peak volume to peak time was longer than that in the supine position.The differences were statistically significant(P<0.05）.The results of blood gas analysis showed that the blood gas analysis index of patients using supine position for mechanical ventilation was better than that in lateral decubitus group,and the proportion of lung infection in supine group was lower than that in lateral supine group,the differences were statistically significant(P<0.05）.There was no significant difference in the average length of stay between the two groups(P＞0.05）.Conclusion when the patients adopt the lateral position,the decrease of lung compliance caused by the decrease of the muscle activity of the respiratory tract leads to the further decrease of its tidal volume,and the peak volume ratio and the peak time ratio will increase because of the improvement of the airway obstruction and the decline of the tidal volume.On the supine,the increase of tidal volume due to the increase of lung compliance has successfully improved the therapeutic effect of mechanical ventilation and improved the internal environment disturbance of patients.
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