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Intra‐arterial blood pressure reading in intensive care unit patients in the lateral position
Authors:Marcel JH Aries  Adnan Aslan  Jan Willem J Elting  Roy E Stewart  Jan G Zijlstra  Jacques De Keyser  Patrick CAJ Vroomen
Institution:1. Authors:?Marcel JH Aries, MD, Resident of Neurology, Department of Neurology, University Medical Centre Groningen;2. Adnan Aslan, MD, Consultant, Department of Critical Care, University Medical Centre Groningen;3. Jan Willem J Elting, MD, PhD, Consultant of Neurology, Department of Neurology, University Medical Centre Groningen;4. Roy E Stewart, PhD, Statistician, Department of Health Sciences, University Medical Centre Groningen;5. Jan G Zijlstra, PhD, Professor, Department of Critical Care, University Medical Centre Groningen;6. Jacques De Keyser, PhD, Professor, Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands and Department of Neurology, Free University Brussels, Brussels, Belgium;7. Patrick CAJ Vroomen, MD, PhD, Consultant of Neurology, Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands
Abstract:Background. Routine lateral turning of patients has become an accepted standard of care to prevent complications of immobility. The haemodynamic and oxygenation effects for patients in both lateral positions (45°) are still a matter of debate. We aimed to study the effect of these positions on blood pressure, heart rate and oxygenation in a general intensive care population. Design. Observational study. Method. Twenty stable intensive care unit patients had intra‐arterial blood pressure recordings in the supine and lateral positions with the correction of hydrostatic height compared with a fixed reference point (phlebostatic level). A multilevel model was used to analyse the data. Results. Mean arterial pressure readings in the lateral positions were, on average, 5 mmHg higher than in the supine position (p < 0·001). There were no significant differences between mean arterial pressure recordings in the left and right lateral position (p = 1·0). No important differences in oxygenation and heart rate were observed. After correction for covariates, the effects persisted. Conclusion. Our study demonstrated an increase, albeit small, in blood pressure in the lateral positions. No major differences between the left and right lateral position were found. No important differences in oxygenation and heart rate were observed. Relevance to clinical practice. Turning haemodynamically stable patients in the intensive care unit has no important effects on blood pressure measurements when continuous hydrostatic height correction is applied.
Keywords:blood pressure  body position  critically ill  intra‐arterial  lateral body position  routine turning
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