The Effect of Upper Limb Elevation on Limb Edema and Central Venous Pressure in ICU Patients
Archives of Critical Care Medicine,
Vol. 1 No. 2 (2015),
27 October 2023
Abstract
Background: Patients admitted to ICU are susceptible to different complications, such as extremities edema. Proper nursing intervention is one of the important aspects of ICU patient’s care. Objectives: The aim of this study was to determine the effects of hand elevation to reduce hand edema and intravenous volume of ICU patients.
Patients and Methods: This experimental clinical study was conducted on 40 ICU patients in hospitals affiliated to Kerman university of medical sciences, Kerman, Iran. During five consecutive days, we randomly elevated one hand of patients with edema, using a 30-degree inclined plane and fixed it for 30 minutes. In each session, before and after limb elevation, central venous pressure (CPV), size of the wrist and the midsection of the arm were measured and recorded.
Results: Elevating upper limb was effective to reduce hand edema and increasing CVP of ICU patients (P < 0.05). In addition, there was a meaningful association between gender and reduction of arm edema (P = 0.04), and between GCS and wrist edema (P = 0.02).
Conclusions: Raising upper limb as a low expense method without any complications could be efficient to reduce hand edema of ICU patients and improve effective intravascular volume.
- Edema
- Limb
- Pressure
How to Cite
References
Villeco JP. Edema: a silent but important factor. J Hand Ther.
;25(2):153–61.
Urden LD, Stacy KM, Lough ME. Thelan's critical care nursing diagnosis and management. St Louis: Mosby Elsevier; 2010.
Burton D, Rose BD. Pathophysiology and etiology of edema-II. 2000.
Available from: http://www.pedneph.info.
Lotfi MT. [Lymphedema]. Q J Breast Disease. 2008;1:50–3.
Black JM, Hawks J. Text Book of Medical Surgical Nursing. New York:
Elsevier; 2009.
Vasudevan SV, Melvin JL. Upper extremity edema control: rationale of the techniques. Am J Occup Ther. 1979;33(8):520–3.
Mader K, Kirchner S, Wolfgarten B, Pennig D. Efficacy of the AV
Impulse System versus cryotherapy in the reduction of postoperative oedema of the hand: a prospective randomised trial.
Strategies Trauma Limb Reconstr. 2006;1(1):36–41.
Giudice ML. Effects of continuous passive motion and elevation
on hand edema. Am J Occup Ther. 1990;44(10):914–21.
Nemeth AJ, Falanga V, Alstadt SP, Eaglstein WH. Ulcerated edematous limbs: effect of edema removal on transcutaneous oxygen
measurements. J Am Acad Dermatol. 1989;20(2 Pt 1):191–7.
Krouskop TA, Reddy NP, Spencer WA, Secor JW. Mechanisms
of decubitus ulcer formation--an hypothesis. Med Hypotheses.
;4(1):37–9.
Kawasaki T, Uemura T, Matsuo K, Masumoto K, Harada Y, Chuman
T, et al. The effect of different positions on lower limbs skin perfusion pressure. Indian J Plast Surg. 2013;46(3):508–12.
Tsang KK, Hertel J, Denegar CR. Volume Decreases After Elevation and Intermittent Compression of Postacute Ankle Sprains
Are Negated by Gravity-Dependent Positioning. J Athl Train.
;38(4):320–4.
Fagan DJ, Evans A, Ghandour A, Prabhkaran P, Clay NR. A controlled clinical trial of postoperative hand elevation at home following day-case surgery. J Hand Surg Br. 2004;29(5):458–60.
Boland RA, Adams RD. The effects of arm elevation and overnight head-up tilt on forearm and hand volume. J Hand Ther.
;11(3):180–90.
Baker RP, Field J, Gozzard C, Wyatt MC, Robertson Y. Does postoperative hand elevation reduce swelling? A randomized study. J
Hand Surg Eur Vol. 2010;35(3):192–4
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