Effects of the beach chair position on respiratory mechanics in patients with chronic obstructive pulmonary disease hospitalized in intensive care unit.

Abstract

Background: Chronic obstructive pulmonary disease (COPD), which exhibits high morbidity and mortality rates, is a respiratory illness associated with persistent airflow obstruction. This study aimed to examine effects of beach chair position on respiratory mechanics in individuals with COPD hospitalized in intensive care unit (ICU) to assess its effectiveness compared to supine position.

Methods: Forty-six participants with COPD, admitted to the ICU and receiving either invasive or non-invasive mechanical ventilation were included in this prospective study. The subjects were initially placed in the supine position. After a few hours, the patients were positioned to spend at least 16 h a day in the beach chair position. Mechanical ventilator data were recorded every hour in each position. The primary outcome of this study included comparison of compliance, elastance, and peak airway resistance, time constant, airway resistance, pH, pCO2 and pO2 data in supine and beach chair positions.

Results: In compared with supine positioning, beach chair positioning resulted in significant enhancement in compliance (35.98 ± 17.51 mL/cmH₂O vs. 44.69 ± 28.74 mL/cmH₂O, p- value = 0.009) and elastance (29.59 ± 11.87 cmH₂O/L vs. 39.86 ± 41.55 cmH₂O/L, p-value = 0.009) whereas peak airway pressure, time constant, airway resistance, pH, pCO₂ and pO₂ did not significantly differ between supine and beach chair position.

Conclusions: Beach chair positioning improves lung compliance and elastance in individuals with COPD in ICU when compared to supine positioning. This study suggests that the beach chair position may offer significant respiratory benefits in terms of respiratory mechanics for COPD patients.