The Effects Of Positional Change On Hemodynamic Parameters In Spinal Immobilization

Introduction:The use of a long backboard and cervical collar are commonly recommended by international guidelines for spinal immobilization, but both devices may cause several side effects. In a recent study, it was reported that spinal immobilization at 20 degrees eliminated the decrease in pulmonary function secondary to spinal immobilization performed at 0 degrees. Spinal immobilization at 20 degrees is a new recommendation, but other potential effects need to be explored before it can be implemented in clinical use.Study Objective:Hemodynamic observation is important in the management of trauma patients. The aim of this study was to investigate the effect of spinal immobilization at a 20 degrees position instead of 0 degrees on hemodynamic parameters.Methods:This study included 53 healthy volunteers who underwent spinal immobilization in the supine position (0(0)) and in an elevated position (20(0)). Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), left ventricular outflow tract velocity time integral (LVOT-VTI), left ventricular stroke volume (LVSV), cardiac output (CO), inferior vena cava diameter inspiration (IVC diameter insp), IVC diameter expiration (IVC diameter exp), and inferior vena cava collapsibility index (IVC-CI) were measured at the 0(th) and 30(th) minutes of spinal immobilization in both positions. The data were compared for demonstrating the efficiency of both positions in spinal immobilization.Results:A statistically significant difference was found in the parameters of the IVC diameter (exp), IVC diameter (insp), LVOT-VTI, LVSV, and CO through the measurements starting in the 0(th) minute of the transition from 0 degrees to 20 degrees (P <.001). Delta values ( increment ) of hemodynamic parameters ( increment IVC diameter [exp], increment IVC diameter [insp], increment LVOT-VTI, increment SV, increment CO, increment IVC-CI, increment MAP, increment SAP, increment DAP, and increment HR) were similar in spinal immobilization at 0 degrees and 20 degrees.Conclusion:The findings obtained from this study illustrate that spinal immobilization at 20 degrees does not cause clinically significant hemodynamic changes in healthy subjects compared to spinal immobilization at 0 degrees.