Application value of high lateral decubitus position in patients with mechanical ventilation complicated with pulmonary infection in ICU

Objective To investigate the clinical aplication effects of high lateral decubitus position in the patients with mechanical ventilation complicated with pulmonary infection in ICU.

Methods A total of 80 patients with mechanical ventilation complicated with pulmonary infection in ICU were selected as the study objects. A prospective control study was applied, and the patients were divided into the control group and observation group by random number table method(40 cases each group). The low lateral decubitus position of 30° to 45° and high lateral decubitus position of 80° to 135° were applied in the control group and observation group, respectively. The improvement of infection, pulmonary ventilation status, treatment outcome and complication rate were compared between two groups.

Results There was no statistical significance in the gender, age, underlying diseases, acute physiology and chronic health status score Ⅱ, oxygenation index(PaO₂/FiO₂), body mass index, mean arterial pressure, heart rate and respiration between two groups(P>0.05). There was no statistical significance in the body temperature, procalcitonin(PCT) and white blood cell count between two groups after 1 and 3 days of intervention(P>0.05), but the body temperature and PCT in the observation group were significantly lower than those in control group after 5 days of intervention(P < 0.01). After 1 d, 3 d and 5 d of intervention, the partial pressure of carbon dioxide values in the observation groups were lower than those in control group(P < 0.01), and the partial pressure of oxygen and PaO₂/FiO₂ values in the observation group after 3 d and 5 d of intervention were higher than those in control group(P < 0.01). The mechanical ventilation time, tracheal intubation time, ICU stay time and total hospital stay in the observation group were shorter than those in control group(P < 0.05 to P < 0.01), and there was no statistical significance in the 28-day mortality between two groups(P>0.05). There was no statistical significance in the incidence rates of pressure injury, aspiration, catheterization and ventilator-associated pneumonia between two groups(P>0.05).

Conclusions The 80°to 135° high lateral decubation can improve the ventilation function of ICU patients with mechanical ventilation complicated with pulmonary infection, reduce inflammatory response, improve treatment outcome, and do not increase the incidence of complications, which is worthy of clinical application and promotion.