Automated Rotational Therapy for the prevention of Respiratory Complications during Mechanical Ventilation

Abstract

Objective

Test the hypothesis that automated rotational therapy reduces the incidence of respiratory complications associated with mechanical ventilation.

Study Design

A prospective, randomized, multicenter trial.

Methods

Intubated mechanically ventilated patients who were free of respiratory infection were eligible. Patients were randomized to use either a standard intensive care unit bed or an automated rotational bed that could turn the patient up to 32 degrees from the horizontal 8 times per hour. Patients were followed until successful extubation, death, or the development of a lower respiratory tract inflammatory syndrome (LRIS). The development of other clinically important events (ie, cardiac, urinary, gastrointestinal, neuropsychiatric) were also recorded.

Results

There was no significant difference in the incidence of LRIS in the group that used automated rotational beds as compared to the control group (17% vs 26%, p = 0.15). There was a significantly lower incidence of urinary tract infection (11% vs 27%, p < 0.05) in the patients treated with automated rotational beds. Nurses noted the development of anxiety in 8 patients on the automated rotational beds. No other significant differences in the development of other clinical events were observed.

Conclusion

In this study, the automated lateral rotational bed and the turning strategy employed with that bed showed no statistically significant advantage over standard ICU patient-turning procedures in the prevention of lower respiratory tract inflammation. [Respir Care 1999;44(12):1447-1451]