Effect of combined lateral and supine positioning on oxygen saturation in ICU patients during the mechanical ventilator weaning process: A randomized controlled trial

Abstract

Background: Prolonged mechanical ventilation in ICU patients increases mortality risk and length of stay. Ineffective weaning can exacerbate the patient’s condition and further elevate mortality risk due to hypoxemiainduced cellular damage, contributing to ICU overcrowding. Purpose: This study investigates the effect of lateral positioning on oxygen saturation in ICU patients undergoing mechanical ventilator weaning. Methods: A randomized controlled trial (RCT) with block randomization was conducted, enrolling 60 participants assigned to either the intervention group (n = 30) or the control group (n = 30). The intervention group received 5% FiO2 and was repositioned every two hours (right lateral, supine, left lateral), whereas the control group remained supine with 5% FiO2. Oxygen saturation (SaO2) was measured using pulse oximetry before and after the intervention. As the data were not normally distributed, the Mann-Whitney U test was used to compare SaO2 changes between groups, with statistical significance set at p < 0.05. Results: Baseline characteristics, including age, gender, and ventilator duration, were comparable between groups (p > 0.05). The median increase in SaO2 was 6% (IQR: 1–8%) in the intervention group and 1% (IQR: 0–3%) in the control group, with a significant between-group difference of 5% (p < 0.001). A large effect size (η² = 0.68) indicated a substantial impact of lateral positioning on SaO2. Conclusions: Lateral positioning significantly improves oxygen saturation in ICU patients undergoing ventilator weaning, potentially reducing complications associated with prolonged mechanical ventilation.