The Effects of Posture in Ventilation and Perfusion in the Postoperative Patient
Abstract
This study was designed to evaluate the effects of posture on ventilation/perfusion in the postoperative patient. The study emerged from an underlying belief that posture does affect a patient's physiological homeostasis. In present day health care, postoperative patients are most often cared for in the supine position, with infrequent alterations in posture. Effective use of posture in the first forty-eight hours following surgery has the potential of improving ventilation/perfusion and decreasing pulmonary complications. Thirty adult patients who had undergone elective thoracic, vascular, or abdominal surgery comprised the study population. By random sampling numbers, the thirty patients were divided into two groups. One half of the patients (15) were studied in the supine position, with no alteration in position. Arterial blood samples were measured every hour for a total of four samples. The other fifteen patients were studied in the supine, right lateral decubitus, left lateral decubitus, and semi-fowler position. Arterial blood samples were measured one hour following an alteration in position, for a total of four samples. The semi-fowler position proved to be the most effective position to improve ventilation/perfusion in the postsurgical patient, with an increase in the arterial blood sample Pa02 of 27.46mm Hg. The least effective position was the left lateral decubitus, with an increase in the arterial blood sample Pa02 of only 4.2mm Hg. Pulmonary complications are a major postoperative problem despite increased awareness of their occurrence, sophisticated means of recognition, and a better understanding of their causes. It is the hope of this researcher that having the results of this study available will enable nurses to provide postoperative patients with more effective intervention during this postoperative phase, thereby reducing pulmonary complications.