Impact of Repositioning Duration on Cardiorespiratory Status in Ventilated Patients
DOI:
https://doi.org/10.37287/ijghr.v8i3.2677Keywords:
critical care nursing, hemodynamic, mechanical ventilation, repositioning duration, respiratory statusAbstract
Immobilization in mechanically ventilated ICU patients frequently alters cardiorespiratory stability. While regular repositioning is standard nursing care to prevent complications, the optimal duration tolerated before hemodynamic shifts occur remains poorly characterized. Objective to analyze the effect of repositioning and its duration on hemodynamic and respiratory status among mechanically ventilated patients in the Intensive Care Unit. A pre-experimental study with a one-group pretest-posttest design was conducted in the ICU of Telogorejo Hospital, Semarang. A total of 20 mechanically ventilated patients were recruited via accidental sampling. Physiological parameters heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SpO2), respiratory rate (RR), and tidal volume (TV) were measured before and immediately after repositioning until physiological changes occurred (maximum duration 2 hours). Data were analyzed using paired comparative tests and correlation analyses. Repositioning significantly altered all measured cardiorespiratory parameters (p<0.05): HR increased from 89.00 ± 15.45 to 103.00 ± 18.79 bpm (p = 0.003), SBP from 119.00 ± 26.65 to 129.00 ± 23.49 mmHg (p = 0.014), DBP from 63.00 ± 15.68 to 67.00 ± 16.10 mmHg (p = 0.006), SpO2 from 99.00 ± 0.92% to 100.00 ± 0.59% (p = 0.035), RR from 16.00 ± 4.55 to 27.00 ± 9.01 breaths/min (p = 0.000), and TV from 441.00 ± 64.97 to 476.00 ± 76.77 mL (p = 0.002). The mean duration before parameter changes was 46.75 ± 10.42 minutes. Repositioning duration showed a significant moderate positive correlation only with changes in diastolic blood pressure (r = 0.602, p = 0.005), while changes in other parameters were not significantly correlated with duration (p > 0.05). Repositioning induces significant physiological responses in mechanically ventilated patients, with hemodynamic shifts emerging at an average of 47 minutes. Critical care nurses should adopt individualized repositioning intervals tailored to patient stability rather than relying solely on rigid two-hour protocols.
References
Akinosoglou, K., Schinas, G., Almyroudi, M. P., Gogos, C., & Dimopoulos, G. (2023). The impact of age on intensive care. Ageing Research Reviews, 84, 101832. https://doi.org/10.1016/j.arr.2022.101832
American Thoracic Society. (2020). Mechanical Ventilation. Am J Respir Crit Care Med., 196, 3–4..
Aulia, P., Rosyid, F. N., & Suratman. (2025). Pengaruh kombinasi posisi lateral dan supinasi terhadap saturasi oksigen pada pasien icu yang selama proses penyapihan ventilator. Manuju: Malahayati Nursing Journal, 7, 4598–4606.
Bhadade, R., Harde, M., Nadkar, M., Tiwasker, M., Vora, A., Saraf, A., Pal, J., Joshi, S., Sreenivasmurthy, & Souza, R. de. (2023). Clinical Practice Guidelines for Management of Pain, Agitation, Delirium, Immobility, and Sleep Disturbance in the Intensive Care Unit: The ABCDEF Bundle. The Journal of the Association of Physicians of India, 71(7), 11–12. https://doi.org/10.59556/japi.71.0304
Damluji, A. A., Forman, D. E., van Diepen, S., Alexander, K. P., Page, R. L., Hummel, S. L., Menon, V., Katz, J. N., Albert, N. M., Afilalo, J., Cohen, M. G., & American Heart Association Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing. (2020). Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association. Circulation, 141(2), e6—e32. https://doi.org/10.1161/cir.0000000000000741
Fordyce, C. B., Katz, J. N., Alviar, C. L., Arslanian-Engoren, C., Bohula, E. A., Geller, B. J., Hollenberg, S. M., Jentzer, J. C., Sims, D. B., Washam, J. B., van Diepen, S., & American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; and Stroke Council. (2020). Prevention of Complications in the Cardiac Intensive Care Unit: A Scientific Statement From the American Heart Association. Circulation, 142(22), e379—e406. https://doi.org/10.1161/cir.0000000000000909
Gao, Z., Chen, Z., Sun, A., & Deng, X. (2019). Gender differences in cardiovascular disease. Medicine in Novel Technology and Devices, 4, 100025. https://doi.org/https://doi.org/10.1016/j.medntd.2019.100025
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. The Cochrane Database of Systematic Reviews, 6(6), CD009958. https://doi.org/10.1002/14651858.CD009958.pub3
Guidet, B., Vallet, H., Boddaert, J., de Lange, D. W., Morandi, A., Leblanc, G., Artigas, A., & Flaatten, H. (2018). Caring for the critically ill patients over 80: a narrative review. Annals of Intensive Care, 8(1), 114. https://doi.org/10.1186/s13613-018-0458-7
Jarczak, D., Kluge, S., & Nierhaus, A. (2021a). Sepsis-Pathophysiology and Therapeutic Concepts. Frontiers in Medicine, 8, 628302. https://doi.org/10.3389/fmed.2021.628302
Jarczak, D., Kluge, S., & Nierhaus, A. (2021b). Sepsis—Pathophysiology and Therapeutic Concepts. Frontiers in Medicine, 8(May), 1–22. https://doi.org/10.3389/fmed.2021.628302
Jatinugroho, Y. D., & Lontoh, S. O. (2021). Pengaruh perubahan posisi terhadap tekanan darah pada karyawan dan karyawati RSU Purwogondo. 3(1), 192–199.
Kadek, N., Purnamayanti, D., Tondok, S. B., Hanafi, W., & Susasnto, A. (2023). Impact of Semi-Fowler ’ s Position in Chronic Heart Failure ( CHF ) Patients : Scoping Review. 9(11), 1229–1236. https://doi.org/10.29303/jppipa.v9i11.5074
Mahmood, S. S., & Pinsky, M. R. (2018). Heart-lung interactions during mechanical ventilation: the basics. Annals of Translational Medicine, 6(18), 349. https://doi.org/10.21037/atm.2018.04.29
Marshall, J. C., Bosco, L., Adhikari, N. K., Connolly, B., Diaz, J. V, Dorman, T., Fowler, R. A., Meyfroidt, G., Nakagawa, S., Pelosi, P., Vincent, J.-L., Vollman, K., & Zimmerman, J. (2017). What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. Journal of Critical Care, 37, 270–276. https://doi.org/10.1016/j.jcrc.2016.07.015
Martinez, R. H., Liu, K. D., & Aldrich, J. M. (2022). Overview of the Medical Management of the Critically Ill Patient. Clinical Journal of the American Society of Nephrology : CJASN, 17(12), 1805–1813. https://doi.org/10.2215/CJN.07130622
Mustikarani, A., & Mustofa, A. (2020). Peningkatan Saturasi Oksigen Pada Pasien Stroke melalui Pemberian Posisi Head Up. 2018. https://doi.org/10.26714/nm.v1i2.5750
Puspita, D. (2019). Efektifitas Posisi Tidur Miring Kanan Dan Semifowler Terhadap Kualitas Tidur Pada Pasien Gagal Jantung. Jurnal Keperawatan Dan Kesehatan, 10(1), 35–47.
Rackley, C. R. (2020). Monitoring During Mechanical Ventilation. Respiratory Care, 65(6), 832–846. https://doi.org/10.4187/respcare.07812
Roumy, A., Liaudet, L., Rusca, M., Marcucci, C., & Kirsch, M. (2020). Pulmonary complications associated with veno-arterial extra-corporeal membrane oxygenation: a comprehensive review. Critical Care (London, England), 24(1), 212. https://doi.org/10.1186/s13054-020-02937-z
Shang, Y., Pan, C., Yang, X., Zhong, M., Shang, X., Wu, Z., Yu, Z., Zhang, W., Zhong, Q., Zheng, X., Sang, L., Jiang, L., Zhang, J., Xiong, W., Liu, J., & Chen, D. (2020). Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China. Annals of Intensive Care, 10(1), 73. https://doi.org/10.1186/s13613-020-00689-1
Sitepu, S. D. E. U., & Sipayung, S. T. (2022). The Effect Of Early Mobilization Measures On Heart Rate And Breathing Frequency In Patients Congestive Heart Failure (chf) At Lubuk Pakam Grandmed Hospital. JURNAL KEPERAWATAN DAN FISIOTERAPI (JKF). https://api.semanticscholar.org/CorpusID:253435193
Subiyanto. (2018). Pengaruh posisi lateral terhadap status hemodinamik pasien dengan ventilasi mekanik di ruang intensive care unit (ICU) RSUP dr kariadi semarang. Universitas Muhammadiyah Semarang.
Takagi, K., Kimmoun, A., Sato, N., & Mebazaa, A. (2020). Management of Acute Heart Failure during an Early Phase. Int J Heart Fail, 2(2), 91–110. https://doi.org/10.36628/ijhf.2019.0014
Tiruvoipati, R., Gupta, S., Pilcher, D., & Bailey, M. (2020). Management of hypercapnia in critically ill mechanically ventilated patients—A narrative review of literature. Journal of the Intensive Care Society, 21(4), 327–333. https://doi.org/10.1177/1751143720915666
Yundari, A. A. I. D. H., Thrisnadewi, N. L. P., & Nopitawati, N. M. (2023). Effects of Progressive Mobilization on Hemodynamic Status of Bedridden Patients in the Intensive Care Unit (ICU). Jurnal Keperawatan Respati Yogyakarta. https://api.semanticscholar.org/CorpusID:260030178
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
