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Infant ALLNCT05393128

The Effect of Different Positions in Children After Cardiac Surgery

A study testing Experimental Group (Right Lateral position) and Experimental Group (Left Lateral position) in people with Infant ALL, run by Acibadem University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study to determine the effects of giving right lateral, left lateral and supine positions on vital signs and oxygen saturation in children after cardiac surgery. Read more about this study

Who is it for?
Ages 1 month to 1 year
Conditions the study is for
Infant ALL
What is being tested?
Experimental Group (Right Lateral position) and Experimental Group (Left Lateral position)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
78 participants
Where
1 siteTurkey (Türkiye)
Study dates
17 Mar 2022to 20 Jun 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 1 year
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • First time experiencing congenital cardiovascular surgery,
  • Having Bilateral pulmonary atelectasis assessment,
  • Not having any secondary congenital anomaly or chronic disease,
  • Not having any neurologic symptoms,
  • Being between 1 month - 1 year old
  • Not having bilateral circulatory disorder and not having any obstacle to the position,
  • Being Intubated
  • Receiving 1 mg/kg dormicum, 0,1 mcg/kg fentaver infusion

Who cannot join

  • Receiving Extra Corporal Membrane Exygenation support,
  • Admitted to ICU with sternum exposed,
  • Receiving Intraaortic balloon pump support,
  • Being a Pre-op period patient,
  • Having a non-bilateral circulatory disorder,
  • Having unilateral thorax drain,
Show all 9Show fewer
  • Being extubated or being planned for extubation during the study period,
  • Receiving Rocuranium,
  • Not receiving Dormicum or fentaver

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education and Research Hospital

    Istanbul, Kadıköy, 34734

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of Different Positions in Children After Cardiac Surgery On Vital Signs And Oxygen Saturation

The objective of this study to determine the effects of giving right lateral, left lateral and supine positions on vital signs and oxygen saturation in children after cardiac surgery.

Read the detailed description

Convenient ventilation management after pediatric cardiac surgery and the positioning of the patient helps to reduce the maximum intrathoracic pressure and venous stasis of the trunk and upper extremities that facilitates the drainage of the blood in the lungs. Due to the fact that the Pre-operative and post-operative management has tremendously changed for the last years, more detailed and up-to-date information is required related to the effect of the body position on the changes of the lung capacities and the pulmonary function. Based on this reason, this research was designed to determine the effect of three different positions as a randomized controlled prospective study.

In case the unit does not contain as routine any obstacle for position (unilateral oedema, ciculation disorder in the extremities, non-bilateral pulmonary atelectasis or dense infiltration, patients who cannot be administered dormicum or fentaver) right lateral, left lateral and supine positions are given. First positioning; also in routine, the standart position given to the first patients is supine position. The patient is first placed supine. Then his arms and legs are supported with support pillows. Transducer level and cuff pressure are controlled, SpO2 probe, ECG probes are controlled. If there's CVK connection, if there isn't any arterial connection, the cuff is controlled and in order to avoid heat loss the patient is covered after controling the body temperature and the position is completed.

In positioning, the 2nd method is right lateral positioning. In this positioning, the patient bed is straightened. Later on, the patient's SpO2 probe, ECG probes, CVK, arterial and cuff connections are once again moved to the right side of the patient and moved from below the patient's body without contact with the body in order to ensure the connections. Then, the patient is turned to right side with angle of 60 or 90 degrees and back is supported with a pillow from the neck to his sacrum, between the legs is also supported with a pillow. Afterwards, the patient's head is elevated with 45 to 60 degrees. Body temperature is controlled. The body is covered in order to avoid temperature loss and position is completed.

The third position that is used is left lateral position. In this positioning, the patient bed is straightened. Then, the patient's SpO2 probe, ECG probe, CVK, artery and cuff connections are transferred to the left side and the connections are made by passing the connections from below the pillow of the patient without touching the body. Later on, The patient is turned to left side with angle of 60 or 90 degrees to the left and the patient's back is supported with pillow from the neck until the sacrum, between the legs is again covered with a pillow. After that, the patient's head is elevated with 45-60 degrees. Body temperature is controlled, covered in order to avoid temperature loss and position is completed.

In this unit, after performing the applications related to the method used, the patient's vital signs and SpO2 are checked and recorded every half hour in the postoperative 24 hours, and hourly in the following processes.

In this study, implementation and data collection for each group will begin after the patient is admitted to the intensive care unit, after stabilization of the surgery (after the 12th hour). Until this time, the patient's follow-up is done in supine position. After stabilization, with the cooperation of the physician, it will continue to be supported by the right lateral and left lateral positions in addition to the supine position every 2 hours. Vital signs and SpO2 values of the patient will be recorded just before positioning, at the 1st minute, 1st hour and its 2nd hour after positioning.

Conditions
Infant ALL
Being tested
Control group (Supine Position), Experimental Group (Right Lateral position), Experimental Group (Left Lateral position)
Keywords
pediatric heart surgery, position, infant

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Control group (Supine Position)Procedure or surgery

    In this group the patients will be given supine position.

    1. Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
    2. The patient will be given supine position.
    3. The arms and the hands will be elevated and supported, the legs will be elevated and supported.
    4. The patient will be covered.
    5. The patient's vital signs, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.
  • Experimental Group (Right Lateral position)Procedure or surgery

    In this group the patients will be given right lateral position.

    1. Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
    2. The patient will be positioned supine and the bed will be straightened.
    3. Lines, probes will be taken to the right side of the patient and the patient will be turned with 60-90 degrees right lateral and the back will be supported with a pillow along the neck and sacrum.
    4. Between the legs will be supported with pillows.
    5. The patient's head will be elevated with 45-60 degrees.
    6. The patient will be covered :
    7. The patient's vital signs, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.
  • Experimental Group (Left Lateral position)Procedure or surgery

    In this group the patients will be given left lateral position.

    1. Body temperature, heart rate, respiration rate, blood pressure, oxygen saturation and CVP will be recorded before the process.
    2. The patient will be positioned supine and the bed will be straightened.
    3. Lines, probes will be taken to the left side of the patient and the patient will be turned with 60-90 degrees left lateral and the back will be supported with a pillow along the neck and sacrum.
    4. Between the legs will be supported with pillows.
    5. The patient's head will be elevated with 45-60 degrees.
    6. The patient will be covered :
    7. The patient's vital findings, SpO2 levels will be registered right before giving position, on the 1st minute, on the 1st hour and on the 2nd hour from right after giving position.
Study groups in NCT05393128
Study groupRoleWhat they receive
Control group (Supine position)OtherThe patient will remain in the supine position for 2 hours and will be followed up with the physician and nurse. After the patient is given one of the supine position, at any time during the 2-hour follow-up period, in case the patient's vital findings and SpO2 levels are beyond the normal findings, in case of a deterioration in the general condition related to the position or another reason, the position will be terminated with the physician's recommendation and the patient will be excluded from the sample. Or except these, in case the physician evaluates the patient and suggests that the position should be changed, the current position will be terminated, and the patient will be excluded from the sample by making a position change.
Receives: Procedure: Control group (Supine Position)
Experimental Group (Right lateral position)ExperimentalThe patient will remain in the right lateral position for 2 hours and will be followed up with the physician and nurse. After the patient is given one of the right lateral position, at any time during the 2-hour follow-up period, in case the patient's vital findings and SpO2 levels are beyond the normal findings, in case of a deterioration in the general condition related to the position or another reason, the position will be terminated with the physician's recommendation and the patient will be excluded from the sample. Or except these, in case the physician evaluates the patient and suggests that the position should be changed, the current position will be terminated, and the patient will be excluded from the sample by making a position change.
Receives: Procedure: Experimental Group (Right Lateral position)
Experimental Group (Left lateral position)ExperimentalThe patient will remain in the left lateral position for 2 hours and will be followed up with the physician and nurse. After the patient is given one of the left lateral position, at any time during the 2-hour follow-up period, in case the patient's vital findings and SpO2 levels are beyond the normal findings, in case of a deterioration in the general condition related to the position or another reason, the position will be terminated with the physician's recommendation and the patient will be excluded from the sample. Or except these, in case the physician evaluates the patient and suggests that the position should be changed, the current position will be terminated, and the patient will be excluded from the sample by making a position change.
Receives: Procedure: Experimental Group (Left Lateral position)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Body Temperature

    This outcome will be considered as one of the vital signs. Body temperature measurement will be evaluated as axillary.

    Measured: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.

  2. Change in Heart Rate

    Heart rate will be monitored.

    Measured: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.

  3. Change in Blood Pressure

    Blood Pressure will be monitored.

    Measured: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.

  4. Change in Respiratory Rate

    Respiratory rate will be monitored.

    Measured: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.

  5. Change in Oxygen Saturation

    Oxygen Saturation will be monitored.

    Measured: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 May 2022
  2. Study start17 Mar 2022
  3. Primary completion20 Jun 2023
  4. Study completion20 Jun 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
78 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05393128
Sponsor's protocol ID
ATADEK-2021/21
Status last verified
Dec 2023
First submitted
2 Mar 2022
Last updated
19 Dec 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Silva ME, Feuser MR, Silva MP, Uhlig S, Parazzi PL, Rosa GJ, Schivinski CI. Pediatric cardiac surgery: what to expect from physiotherapeutic intervention? Rev Bras Cir Cardiovasc. 2011 Apr-Jun;26(2):264-72. doi: 10.1590/s0102-76382011000200018. English, Portuguese.

    PubMed 21894418
  • Thomas PJ, Paratz JD. Is there evidence to support the use of lateral positioning in intensive care? A systematic review. Anaesth Intensive Care. 2007 Apr;35(2):239-55. doi: 10.1177/0310057X0703500214.

    PubMed 17444315
  • de Laat E, Schoonhoven L, Grypdonck M, Verbeek A, de Graaf R, Pickkers P, van Achterberg T. Early postoperative 30 degrees lateral positioning after coronary artery surgery: influence on cardiac output. J Clin Nurs. 2007 Apr;16(4):654-61. doi: 10.1111/j.1365-2702.2006.01715.x.

    PubMed 17402946
  • Hickey PA, Pasquali SK, Gaynor JW, He X, Hill KD, Connor JA, Gauvreau K, Jacobs ML, Jacobs JP, Hirsch-Romano JC. Critical Care Nursing's Impact on Pediatric Patient Outcomes. Ann Thorac Surg. 2016 Oct;102(4):1375-80. doi: 10.1016/j.athoracsur.2016.03.019. Epub 2016 May 10.

    PubMed 27173065

Questions about this trial

What is this clinical trial studying?

A study testing Experimental Group (Right Lateral position) and Experimental Group (Left Lateral position) in people with Infant ALL, run by Acibadem University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Body Temperature (time frame: Data will be collected immediately before the position is given, at the 1st minute, at the 1st hour and at the 2nd hour after the position is given. The change in these time intervals will be assessed.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05393128, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2023.

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