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Sammanfattning: Background: Immobilization increases the risk of thrombosis, pneumonia and pressure ulcer. Critically ill patients treated in intensive care units (ICU) are often both sedated and intubated and have to be passively turned by health workers to reduce and avoid complications. Turns are there for one of the most frequent tasks for ICU nurses. Recent studies indicate risks with changes in body position in critically ill patients, but there is a lack of studies showing the extent of these risks. Since ICU patients often are hemodynamic and respiratory affected, it is important to increase knowledge about what happens in passive turns to not cause any harm.Purpose: To identify the impact on critically ill patients that could occur as a result from turns.Design and methods: A systematic review of relevant literature was performed with search through Cinahl and PubMed with a subsequent analysis of the result.Results: Twelve quantitative articles where included in the result comprising a total of 630 patients. The main themes were established; Circulation, Respiration and Pain. Respiration was then given three sub themes; Ventilation, Tube position and Ventilator associated pneumonia (VAP). The result showed that patients were affected by turns as they showed increased mean arterial pressure (MAP), pulse and respiratory rate along with changed tube positions and cuff pressure. Furthermore, it was found that pain associated with turns may affect the circulation and respiration.Conclusions: Turning critically ill patients is not without risks. Circulation and respiration can be disturbed up to 45 minutes after a turn. The number of studies investigating risks with turns are low and some studies have excluded hemodynamic and respiratory unstable patients. This makes it hard to draw any conclusions. Further studies looking into the risks with turns of ICU patients is needed.
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