Effect of Changeing Position on Oxygenation and Hemodynamic in Premature Baby

• Main Authors: Yu-Ling Kuo, 郭于鈴
• Other Authors: Yann-Fen Chao
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/88091443857962332896

碩士 === 國立陽明大學 === 臨床護理研究所 === 93 === The purpose of this research is to investigate the impact of body position and position change on oxygenation and hemodynamic status of the premature babies. A repeated measures design of one group clinical observations was adopted. The inclusions criteria were:1) pregnancy 20∼37weeks; 2)born body weight 1000∼2000gm; 3)postconceptional age between 29〜35weeks; 4)on then 2nd or more days after birth; 5)chest x-ray show RDS GrⅠ、Ⅱ,and use ventilation with FiO2 setting＜40%. The exclusive criteria were: 1)congenital heart disease; 2)continue fetal circulation; 3)vital signs were too unstable to be included, as adviced by doctors. The informed consist were obtained form the parents. Each subject was putting in following the positions successively and stayed in each position for 20 minutes: prone with head of bed (HOB) 45°→prone with HOB 0°→right lateral position with HOB 45°→ right lateral position with HOB 0°→supine with HOB 45°→supine with HOB 0°→left lateral position with HOB 45°→left lateral position with HOB 45°. During each position period, heart rate, respiratory rate, blood pressure, SpO2 were monitored and values on every minute were charted. Data were processed by SPSS 12.0/pc and the major statistical procedures applied were: Mean, SD, Maximum, Minimal, independent T-test, paired T-test, and repeated measures ANOVA.A p value of <.05 is used to determine the statistical significance. The values were also illustrated in figures to present the trend of change during position change process. The results were as following: 1. In each position, the heart rate increased in the beginning, reached the highest within 5 minutes, and stabilized in 10minutes. In right lateral position with HOB 45°, the increment of heart rate was the most. 2. In each position, except supine with HOB 45°, the respiratory rate increased in the beginning, reached the highest within 5 minutes, and stabilized in 15 minutes. In right lateral and supine position, the increment of respiratory rate was the most. In prone and left lateral position, the respiratory rate was comparatively more stable then in other positions. In the supine and HOB 45°, the respiratory rate decreased in the beginning, reached the lowest within 5 minutes, and stabilized in 15 minutes. 3. In each position, the SpO2 in prone and HOB 45°positions is significantly the best compared to other positions. 4. In each position, blood pressure in HOB 45° positions is significantly higher then in HOB 0° positions. The increment in blood pressure is concordant with the increase in angle of HOB. The finding of this study provides references in caring premature neonate in choosing and changing position. For neonates with high risk for brain hemorrhage or respiratory distress, choosing a baby position with lese impact on blood pressure or SpO2 may be more appropriate for them. When baby presenting respiratory distress or hemodynamic unstability, change position to one which promotes oxygenation and unload cardiovascular stress will help to stabilized physiological station.