Impact of Verticalization Therapy in a Patient With Acute Respiratory Distress Syndrome and Obesity: A Case Report

INTRODUCTION: Obesity increases the risk of severe acute respiratory distress syndrome, prolonging mechanical ventilation duration and intensive care unit stays. Factors affected by obesity include diaphragm displacement and reduced lung volume. This case report discusses nursing care for a patient who received verticalization therapy, resulting in improved lung volume distribution and oxygenation. CLINICAL FINDINGS AND DIAGNOSIS: A 27-year-old man with obesity was admitted to the intensive care unit and placed on mechanical ventilation due to severe respiratory failure caused by an allergic reaction. Chest radiography revealed lung volume loss, atelectasis, and pulmonary edema. INTERVENTIONS: Within the first 24 hours of admission, the patient required increased ventilator settings, continuous intravenous sedatives, and paralytics. On hospital day 12, the patient was positioned prone to address refractory hypoxemia and acute respiratory distress syndrome. When prone positioning failed to improve oxygenation and ventilation, the patient was placed in a specialty bed to undergo verticalization therapy on hospital day 20. OUTCOMES: Within 24 hours of initiation of verticalization therapy, ventilator settings were decreased. Chest radiographs demonstrated improved lung volumes within 5 days of verticalization therapy initiation. CONCLUSION: This case report enhances the understanding of caring for patients with severe acute respiratory distress syndrome and obesity, emphasizing the critical role of nurse-led verticalization therapy in treating individuals affected by these conditions.