Proper positioning is used to relieve dyspnea, edema, and fatigue in congestive heart failure patients. According to the review of literature, improved ventilation as measured by specific lung volumes and lung mechanics occurred with upright positioning in normal persons. The effects of specific changes in lung volumes related to position change in congestive heart failure patients has not been documented in literature, although various recommendations related to positioning are made. This exploratory study was undertaken with nine congestive heart failure patients to see if a relationship existed between degree of head elevation and lung ventilation ability as measured by water-bell spirometer. Measured volumes were corrected to BTPS values. The patients subjective evaluation of breathing comfort related to position change and ventilation ability was also studied. The positions studied were lying flat in bed with the head elevated 0°, 15°, 30°, 45°, and 60°. The lung volumes measured were tidal volume (TV), inspiratory volume (IRV), expiratory reserve volume (ERV), vital capacity (VC), minute respiratory volume (MRV), forced expiratory volume — timed and reserve per cent — (FEVTand FEV%,), and inspiratory capacity (IC) . evaluation of comfort was rated on a scale of 0 (uncomfortable) to 3 (most comfortable). ventilation ability with changes in position. Subjective The results showed that there was a change in Individual patients had statistically significant relationships of position change to ventilation Because of ability. the great variation of individual values obtained, ERV, FEVT, FEV% and MRV and decreased TV, IC, IRV, and VC, with the subjective evaluation of increased comfort. The actual volumes and capacities measured did not have a linear relationship of volume change with increasing position change. The means of the values for measured volumes had a regular pattern of low at 0°, lower at 15°, high at 30°, slightly higher or slightly lower at 45°, and highest at 60° for all volumes except IRV and IC. Recommendations are made for the utilization of the data for further research and for implications related to patient care.

LLU Discipline





Graduate School

First Advisor

R. Maureen Maxwell

Second Advisor

L. Lucile Lewis

Third Advisor

Jane Mundin

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Heart Failure; Congestive Pulmonary Circulation



Page Count

xi; 128

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives