The following is a summary of “Physiological and clinical effects of trunk inclination adjustment in patients with respiratory failure: a scoping review and narrative synthesis,” published in the July 2024 issue of Critical Care by Benites et al.

Tilting a patient with respiratory failure trunk inclination from semi-recumbent to supine-flat or vice versa significantly impacts breathing mechanics, oxygen levels, and lung function, but optimal positioning practices still need more research.

Researchers conducted a retrospective study evaluating how trunk inclination affects lung physiology in patients on MV with respiratory failure.

They searched databases like PubMed, Cochrane, and Scopus from 2003 to 2023, focusing on interventions involving changes in trunk inclination. The main 4 key domains, including respiratory mechanics, ventilation distribution, oxygenation, and ventilatory efficiency, were evaluated.

The result showed a screening of 20 studies, 37 of which were examined in detail, and 13 met the inclusion criteria, involving 274 patients. All included studies were experimented with and evaluated respiratory mechanics, ventilation distribution, oxygenation, and ventilatory efficiency, predominantly within 60 minutes after the postural change.

Investigators concluded that changing position to a semi-recumbent in patients with acute respiratory failure affects respiratory mechanics and efficiency, necessitating precise reporting of trunk inclination angles during MV.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05010-1