Johnson Karen L, Meyenburg Tim
University of Maryland Medical Center, 22 S Greene St, 7 Gudelsky, Room C728, Baltimore, MD 21201, USA.
AACN Adv Crit Care. 2009 Jul-Sep;20(3):228-40; quiz 241-2. doi: 10.1097/NCI.0b013e3181add8db.
Prolonged bed rest is common in critically ill patients, and therapeutic positioning is important to prevent further complications and to improve patient outcomes. Nurses use therapeutic positioning to prevent complications of immobility. This article reviews therapeutic positions including stationary positions (supine, semirecumbent with head of bed elevation, lateral, and prone) and active repositioning (manual, continuous lateral rotation, and kinetic therapy). The physiological rationale and current evidence for each position are described. Applicable evidence-based practice guidelines are summarized. Special considerations for therapeutic positioning of critically ill obese and elderly patients are also discussed.
长时间卧床休息在重症患者中很常见，治疗性体位摆放对于预防进一步并发症和改善患者预后很重要。护士采用治疗性体位摆放来预防活动受限的并发症。本文综述了治疗性体位，包括静态体位（仰卧位、床头抬高的半卧位、侧卧位和俯卧位）以及主动重新摆放体位（手法、连续侧方旋转和动力治疗）。描述了每个体位的生理原理和当前证据。总结了适用的循证实践指南。还讨论了重症肥胖和老年患者治疗性体位摆放的特殊注意事项。
