Effectiveness of Right Lateral Position on Oxygen Saturation and Respiratory Rate in Children with Pneumonia
DOI:
https://doi.org/10.37287/ijghr.v8i5.2715Keywords:
children, oxygen saturation, pneumonia, right lateral position, respiratory rateAbstract
Pneumonia is a leading cause of morbidity and mortality in children, often accompanied by impaired gas exchange, decreased oxygen saturation, and increased respiratory rate. Non-pharmacological interventions such as body positioning have the potential to improve pulmonary ventilation-perfusion and enhance a child's respiratory status. This study analyzed the effectiveness of the right lateral position compared to the semi-Fowler position on oxygen saturation and respiratory rate in children with pneumonia. This research method used a quasi-experimental pretest-posttest design with a control group design. The sample consisted of 30 children aged 1 month to 5 years with pneumonia selected using purposive sampling, consisting of 15 respondents in the intervention group who received the right lateral position and 15 respondents in the control group who received the semi-Fowler position. Oxygen saturation and respiratory rate were measured before and after the intervention using a standardized observation sheet. Data were analyzed using a paired t-test and an independent t-test with a significance level of 95% (α = 0.05). The baseline characteristics of respondents in both groups were homogeneous (p>0.05). In the right lateral group, oxygen saturation increased from 91.2±4.9% to 95.8±3.5% (Δ=4.6; p=0.001), while the respiratory rate decreased from 43.3±4.7 to 36.2±3.0 beats/minute (Δ=7.1; p=0.001). In the semi-Fowler group, oxygen saturation increased from 90.6±6.7% to 94.4±4.6% (Δ=3.8; p=0.001), and the respiratory rate decreased from 43.1±6.5 to 37.1±4.5 beats/minute (Δ=5.9; p=0.001). Changes in oxygen saturation (p=0.032) and respiratory rate (p=0.018) were significantly different between groups. The effect size showed a superior right lateral position on oxygen saturation (d=0.32) and respiratory rate (d=0.38). Conclusion: The right lateral position is more effective than the semi-Fowler's position in increasing oxygen saturation and decreasing respiratory rate in children with pneumonia.
References
Abebe, T. N., & Goshu, A. T. (2025). Bayesian modeling of oxygen saturation (SpO₂) of cardiac patients using the asymmetric generalized error distribution. BMC Pediatrics, 25(1).https://doi.org/10.1186/S12887-025-06094-6
Agustina, N., Nurhaeni, N., & Hayati, H. (2021). Right Lateral Position Can Improve Oxygen Saturation And Respiratory Rate In Under-Five Children With Pneumonia. Pediatria Medica E Chirurgica, 43(S1). https://Doi.Org/10.4081/Pmc.2021.262
Agustina Novita, NN (2020). The Influence of Settings on Health Status in Children with Pneumodialysis: A Literature Review. Novita Agustina, Nani Nurhaeni. Nursing World: Journal of Nursing and Health, 189–198.Https://Doi.Org/10.20527/Dk.V8i1.7776
Alan, N., & Khorshid, L. (2021). The effects of different positions on oxygen saturation and vital signs in patients with pulmonary diseases: A systematic review. Intensive and Critical Care Nursing, 62, 102943.https://doi.org/10.1016/j.iccn.2020.102943
Alghamdi, SM, Alqahtani, JS, & Aldhahir, AM (2023). Body positioning and respiratory outcomes in pediatric respiratory diseases: A systematic review. Children, 10(4), 712.https://doi.org/10.3390/children10040712
Anwar, A., & Dharmayanti, I. (2014). Pneumonia among children under five years of age in Indonesia. Health Science Journal of Indonesia, 5(2), 75–80.
Beitler, J.R., Malhotra, A., & Thompson, B.T. (2023). Ventilator and positioning strategies in acute respiratory failure. The New England Journal of Medicine, 388(12), 1121–1132.https://doi.org/10.1056/NEJMra2208270
Bhandari, A.P., Nnate, D.A., Vasanthan, L., Konstantinidis, M., & Thompson, J. (2022). Positioning for acute respiratory distress in hospitalized infants and children. Cochrane Database of Systematic Reviews, 2022(6).https://doi.org/10.1002/14651858.CD003645.pub4
Bhandari, S., Rankawat, G., & Singh, A. (2022). Effects of body positioning on breathingmechanics and oxygenation: A review. Respiratory Care, 67(8), 987–995.https://doi.org/10.4187/respcare.09741
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Curley, MAQ, Hibberd, P.L., Fineman, L.D., Wypij, D., Shih, M.C., Thompson, J.E., Grant, J.C., Barr, F.E., Cvijanovich, N.Z., Sorce, L., Luckett, P.M., Matthay, M.A., & Arnold, J.H. (2005). Effect of prone positioning on clinical outcomes in children with acute lung injury: A randomized controlled trial. JAMA, 294(2), 229–237.https://doi.org/10.1001/jama.294.2.229
Esteban-Gavilán, C.B., Rico-Mena, P., Güeita-Rodríguez, J., Navarro-López, V., & Escudero-Romero, R. (2024). Respiratory physiotherapy interventions in pediatric population with atelectasis: A systematic review. Children, 11(11), 1364.https://doi.org/10.3390/children11111364
Funder, D.C., & Ozer, D.J. (2021). Evaluating effect size in psychological research: Sense and nonsense. Advances in Methods and Practices in Psychological Science, 4(2), 1–12.https://doi.org/10.1177/25152459211012287
Hayward, N., Shaban, M., Badger, J., Jones, I., Wei, Y., Spencer, D., Isichei, S., Knight, M., Otto, J., Rayat, G., Levett, D., Grocott, M., Akerman, H., & White, N. (2022). A capaciflector provides continuous and accurate respiratory rate monitoring for patients at rest and during exercise. Journal of Clinical Monitoring and Computing, 36(5), 1535–1546.https://doi.org/10.1007/S10877-021-00798-7
Herbert, A., O'Driscoll, B., & Murphy, P. (2020). Respiratory rate as a predictor of clinical improvement in pediatric respiratory disorders. Archives of Disease in Childhood, 105(7), 623–628.https://doi.org/10.1136/archdischild-2019-317284
Hilpriska Danal, P., Nurhaeni, N., & Wanda, D. (2021). The effect of lateral position in improving oxygen saturation and respiratory rate in children with oxygenation problems in pediatric infectious wards.
Indonesian Pediatrician Association. (2017). Suppressing pneumonia.http://www.idai.or.id/artikel/klinik/pengasuhan-anak/menekan-pneumonia
Kallet, R.H. (2022). A comprehensive review of prone and lateral positioning in acute respiratory failure. Respiratory Care, 67(5), 625–639.https://doi.org/10.4187/respcare.09815
Ministry of Health of the Republic of Indonesia. (2024). Indonesia's health profile 2024. Ministry of Health of the Republic of Indonesia.
Kheir, F., Alokla, K., & Myers, L. (2022). Impact of body positioning on respiratory mechanics and oxygenation. Chest, 161(4), 1052–1061.https://doi.org/10.1016/j.chest.2021.10.041
Koni Agustyana, Praba Ginandjar, LDS, & Hidayati, R. (2019). The relationship between physical conditions of the house and the incidence of pneumonia in toddlers in urban areas (Study in the Bergas Community Health Center work area). Journal of Public Health, 7(1), 1–9.
Kwon, H., Kim, S., & Lee, J. (2023). Effects of positioning interventions on respiratory outcomes in hospitalized children: A systematic review and meta-analysis. Journal of Pediatric Nursing, 71, e45–e53.https://doi.org/10.1016/j.pedn.2023.01.008
Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1), Article 33267.https://doi.org/10.1525/collabra.33267
Mawaddah, E., Nurhaeni, N., & Wanda, D. (2018). Do different positions affect the oxygen saturation and comfort level of children under five with pneumonia? Enfermería Clínica, 28(Suppl. 1), 9–12.https://doi.org/10.1016/S1130-8621(18)30027-5
Nishant, K., Sharma, P., & Gupta, R. (2024). Positioning interventions and oxygenation outcomes in pediatric pneumonia: A systematic review. Pediatric Critical Care Medicine, 25(3), 145–153.https://doi.org/10.1097/PCC.0000000000003395
Ogilvie, C. M., Dorrington, K. L., & Grocott, M. P. W. (2021). Physiological effects of body positioning on ventilation-perfusion matching and oxygenation. Anaesthesia, 76(Suppl. 1), 52–60.https://doi.org/10.1111/anae.15266
Qin, W., Mao, L., Shen, Y., & Zhao, L. (2024). Prone position in the mechanical ventilation of acute respiratory distress syndrome children: A systematic review and meta-analysis. Frontiers in Pediatrics, 12, 1293453.https://doi.org/10.3389/fped.2024.1293453
Serdar, C. C., Cihan, M., Yücel, D., & Serdar, M. A. (2021). Sample size, power and effect size revisited: Simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochemia Medica, 31(1), 010502.https://doi.org/10.11613/BM.2021.010502
Sullivan, G. M., & Feinn, R. (2021). Using effect size or why the p value is not enough. Journal of Graduate Medical Education, 13(2), 279–282.https://doi.org/10.4300/JGME-D-21-00076.1
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.
