Hemodynamic and Ventilatory Responses to Head-down Postural Drainage Position
Hemodynamic and Ventilatory Responses to Head-down Postural Drainage Position
The purpose of this study is to explore acute hemodynamic and ventilatory responses to
 head-down 30 degree postural drainage position in patients with blunt chest and/or abdominal
 injury in the traumatic intensive care unit.
Study Protocol The study protocol consisted of 2 conditions: treatment condition (A) and sham
 condition (B). The order of the conditions was randomly assigned to either the treatment or
 sham for the first round and vise versa in the second round in a balanced cross-over design
 (A-B-B-A) so there were four sets of measurements per patient.

 For the treatment condition (A), the study consists of three consecutive periods 1) baseline
 period: 10 minutes rest in horizontal supine lying 2) intervention period: 10 minutes rest in
 head-down 30 degree supine lying 3) recovery period: return to horizontal supine lying and
 rest for 10 minutes . For the Sham condition (B), the study was performed with a similar
 procedure except the intervention period consisted of horizontal supine lying.

 Hemodynamic and ventilatory parameter were recorded at the start of each period (0 min) and
 every 2 minute until end of each period for both conditions. Hemodynamic and ventilatory
 dependent variables were heart rate (HR), systolic blood pressure (SBP), diastolic blood
 pressure (DBP), mean arterial pressure (MAP), electrocardiography (ECG), central venous
 pressure (CVP), respiratory rate (RR), oxygen saturation (SpO2), tidal volume (VT), minute
 ventilation (VE), dynamic lung compliance (Cdyn) and end-tidal expiratory pressure of CO2
 (PETCO2). Subjects were rested between each condition. Subjects were suctioned via
 endotracheal tube to clear airway at 10 minutes before study commencement of either A-B or
 B-A.
Inclusion Criteria:

 -  Mechanical ventilator dependence

 -  Stable cardiopulmonary function at rest (HR 60-100 beats/min, systolic BP 90-140 mmHg
 and diastolic BP 60-90 mmHg and SpO2>95%. RR 10-20 breath/min

 Exclusion Criteria:

 -  Spine disorders such as spine fracture, HNP, spondylolisthesis, whiplash syndrome,
 stenosis and spondylosis

 -  Fracture of upper and/or lower limbs

 -  Underlying acute or chronic cardiopulmonary diseases

 -  Craniotomy or craniectomy

 -  Unstable intracranial pressure, ICP>12 cmH2O

 -  Uncontrolled pain