The Effect of Different Positions in Children After Cardiac Surgery
Condition: Infant ALL
Study type: Interventional

Summary: 
      The objective of this study to determine the effects of giving right lateral, left lateral
      and supine positions on vital signs and oxygen saturation in children after cardiac surgery.
    

Detailed description: 
      Convenient ventilation management after pediatric cardiac surgery and the positioning of the
      patient helps to reduce the maximum intrathoracic pressure and venous stasis of the trunk and
      upper extremities that facilitates the drainage of the blood in the lungs. Due to the fact
      that the Pre-operative and post-operative management has tremendously changed for the last
      years, more detailed and up-to-date information is required related to the effect of the body
      position on the changes of the lung capacities and the pulmonary function. Based on this
      reason, this research was designed to determine the effect of three different positions as a
      randomized controlled prospective study.

      In case the unit does not contain as routine any obstacle for position (unilateral oedema,
      ciculation disorder in the extremities, non-bilateral pulmonary atelectasis or dense
      infiltration, patients who cannot be administered dormicum or fentaver) right lateral, left
      lateral and supine positions are given. First positioning; also in routine, the standart
      position given to the first patients is supine position. The patient is first placed supine.
      Then his arms and legs are supported with support pillows. Transducer level and cuff pressure
      are controlled, SpO2 probe, ECG probes are controlled. If there's CVK connection, if there
      isn't any arterial connection, the cuff is controlled and in order to avoid heat loss the
      patient is covered after controling the body temperature and the position is completed.

      In positioning, the 2nd method is right lateral positioning. In this positioning, the patient
      bed is straightened. Later on, the patient's SpO2 probe, ECG probes, CVK, arterial and cuff
      connections are once again moved to the right side of the patient and moved from below the
      patient's body without contact with the body in order to ensure the connections. Then, the
      patient is turned to right side with angle of 60 or 90 degrees and back is supported with a
      pillow from the neck to his sacrum, between the legs is also supported with a pillow.
      Afterwards, the patient's head is elevated with 45 to 60 degrees. Body temperature is
      controlled. The body is covered in order to avoid temperature loss and position is completed.

      The third position that is used is left lateral position. In this positioning, the patient
      bed is straightened. Then, the patient's SpO2 probe, ECG probe, CVK, artery and cuff
      connections are transferred to the left side and the connections are made by passing the
      connections from below the pillow of the patient without touching the body. Later on, The
      patient is turned to left side with angle of 60 or 90 degrees to the left and the patient's
      back is supported with pillow from the neck until the sacrum, between the legs is again
      covered with a pillow. After that, the patient's head is elevated with 45-60 degrees. Body
      temperature is controlled, covered in order to avoid temperature loss and position is
      completed.

      In this unit, after performing the applications related to the method used, the patient's
      vital signs and SpO2 are checked and recorded every half hour in the postoperative 24 hours,
      and hourly in the following processes.

      In this study, implementation and data collection for each group will begin after the patient
      is admitted to the intensive care unit, after stabilization of the surgery (after the 12th
      hour). Until this time, the patient's follow-up is done in supine position. After
      stabilization, with the cooperation of the physician, it will continue to be supported by the
      right lateral and left lateral positions in addition to the supine position every 2 hours.
      Vital signs and SpO2 values of the patient will be recorded just before positioning, at the
      1st minute, 1st hour and its 2nd hour after positioning.
    

Intervention name(s): Control group (Supine Position); Experimental Group (Right Lateral position); Experimental Group (Left Lateral position)
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): In this group the patients will be given supine position.
Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
The patient will be given supine position.
The arms and the hands will be elevated and supported, the legs will be elevated and supported.
The patient will be covered.
The patient's vital signs, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.; In this group the patients will be given right lateral position.
Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
The patient will be positioned supine and the bed will be straightened.
Lines, probes will be taken to the right side of the patient and the patient will be turned with 60-90 degrees right lateral and the back will be supported with a pillow along the neck and sacrum.
Between the legs will be supported with pillows.
The patient's head will be elevated with 45-60 degrees.
The patient will be covered :
The patient's vital signs, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.; In this group the patients will be given left lateral position.
Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
The patient will be positioned supine and the bed will be straightened.
Lines, probes will be taken to the left side of the patient and the patient will be turned with 60-90 degrees left lateral and the back will be supported with a pillow along the neck and sacrum.
Between the legs will be supported with pillows.
The patient's head will be elevated with 45-60 degrees.
The patient will be covered :
The patient's vital findings, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: pediatric heart surgery; position; infant