[Efficacy of sequential lateral position management in patients with chronic wounds and pulmonary complications: a prospective RCT].

Objective

To investigate the efficacy of sequential lateral position management in patients with chronic wounds and pulmonary complications.

Methods

This study was a prospective randomized controlled trial (RCT). From January 2023 to December 2024, 48 patients with chronic wounds and pulmonary complications who met the inclusion criteria were admitted to the Department of Burns and Plastic (Reconstructive) Surgery of Zhangjiagang Hospital Affiliated to Soochow University. They were randomly divided into control group (n=24, 13 males and 11 females, aged (76±12) years) and experimental group (n=24, 12 males and 12 females, aged (76±12) years) using an envelope method, and underwent conventional position management and sequential lateral position management based on conventional position management protocol, respectively, with a period of 7 days. On the 1st and 7th day of body position management, blood gas analysis parameters (including partial pressure of arterial oxygen (PaO₂), arterial oxygen saturation (SaO₂), and partial pressure of arterial carbon dioxide (PaCO₂)) as well as safety indicators such as respiratory rate in both groups of patients were statistically analyzed. Additionally, from the 1st to 7th days of body position management, sputum volume grading (mild, moderate, and severe), along with the frequency of complications and adverse events (aspiration, arrhythmia, skin injury, endotracheal tube displacement, and unplanned extubation, etc.) were statistically analyzed.

Results

Compared with those in control group, the differences in PaO2, SaO2, and PaCO2 between the 7th day and the 1st day of body position management of patients in experimental group were statistically significant (with F values of 15.50, 18.79, and 10.13, respectively, P<0.05). On the 7th day of body position management, the PaO2 of patients in experimental group was (102±24) mmHg (1 mmHg=0.133 kPa), which was higher than (79±16) mmHg in control group. Compared with that in control group, the respiratory rate difference between the 7th day and the 1st day of body position management of patients in experimental group was statistically significant (F=15.17, P<0.05). From the 1st to 7th days of body position management, there was no statistically significant difference in sputum volume grading between the two groups of patients (P>0.05). No related complications or adverse events such as aspiration, arrhythmia, skin injury, endotracheal tube displacement, and unplanned extubation occurred in the two groups of patients.

Conclusions

The RCT shows that for patients with chronic wounds and pulmonary complications, sequential lateral position management can improve pulmonary ventilation function, improve oxygenation, correct hypoxemia, reduce respiratory rate, promote pulmonary rehabilitation of patients, and is safe and reliable.