Continuous oscillation: Outcome in critically III patients

Traver, Gayle A.; Tyler, Martha L.; Hudson, Leonard D.; Sherrill, Duane L.; Quan, Stuart F.

doi:10.1016/0883-9441(95)90000-4

Cited by 52 publications

(21 citation statements)

References 15 publications

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“…The modest efficacy effect size is consistent with the findings of previous studies wherein investigators found a reduction in noninfectious (eg, atelectasis) 14,21 and/or infectious (eg, pneumonia) 14,16,18,19,22 PPCs in adult patients receiving mechanical ventilation in medical-surgical ICUs. In the 2 studies 17,20 with no significant reduction, the mean turn angle was 25°o r less, compared with 34° in the present study; other trials in this population of patients did not (11) 100 (0) 87 (11) 33 (24) 94 (5) 91 (4) 51 ( …”

Section: Manual-turn Group (N = 7)contrasting

confidence: 64%

“…Automated turning has been tested in randomized controlled trials with medical-surgical ICU patients who are receiving mechanical ventilation, 14,[16][17][18][19][20][21][22] and researchers in all but 2 studies 17,20 reported a significant reduction in PPCs. Researchers in 2 studies 16,22 reported shorter ICU stays in patients receiving automated turning, and researchers in another study 16 also reported decreased duration of mechanical ventilation.…”

mentioning

confidence: 99%

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Manual vs Automated Lateral Rotation to Reduce Preventable Pulmonary Complications in Ventilator Patients

Hanneman

Gusick

Hamlin

et al. 2014

American Journal of Critical Care

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Purpose To estimate effect sizes for a trial to compare preventable pulmonary complications (PPCs), turning-related adverse events, mechanical ventilation duration, intensive care unit (ICU) length of stay, and ICU mortality between patients randomized to 2-hourly manual or continuous automated lateral rotation. Methods Randomized controlled trial pilot study with 15 patients selected randomly from eligible medical-surgical ICU patients from 2 tertiary hospitals and assigned randomly to the manualturn or automated-turn protocol for up to 7 consecutive days. A radiologist blinded to group and site assessed serial chest radiographs for PPCs. Repeated-measures analysis with linear mixed models was used to estimate change in PPC score, and Wilcoxon rank sum or Fisher exact test was used to compare group differences in the secondary outcomes. Results Of 16 patients enrolled, 12 (75%) completed the study. Data from 15 patients, 7 manual turn and 8 automated turn, were analyzed. Between-group differences in PPC incidence (67% overall), change in PPC score (β = 0.15, manual turn and β = -0.44, automated turn), and secondary outcomes were not significant (P > .05). Standardized effect sizes were small to moderate for the outcome variables. A sample size of 54 patients would be needed to detect statistically significant between-group differences in PPC over time. Conclusions The incidence of PPCs in adult patients receiving mechanical ventilation in a medical-surgical ICU was high. Automated turning decreased PPCs with time but had little effect on secondary outcomes. Safety outcomes were not substantially different between groups. A modest efficacy effect supported reduced PPCs with automated turning to the lateral position.

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Section: Manual-turn Group (N = 7)contrasting

confidence: 64%

mentioning

confidence: 99%

Manual vs Automated Lateral Rotation to Reduce Preventable Pulmonary Complications in Ventilator Patients

Hanneman

Gusick

Hamlin

et al. 2014

American Journal of Critical Care

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“…Nonetheless, a recent survey by the University Hospital Consortium revealed that compliance with the simple and no-cost intervention of elevating the head is woefully low, and a study by Heyland et al revealed that the head of bed is on average elevated to 29°and not 45° (80). Kinetic bed therapy has also led to a reduction in the incidence of VAP (46,48,69,72,97,202,213). However, this is costly and has not been directly compared to head-of-bed elevation, a nocost option.…”

Section: Preventionmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

2006

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SUMMARY While critically ill patients experience a life-threatening illness, they commonly contract ventilator-associated pneumonia. This nosocomial infection increases morbidity and likely mortality as well as the cost of health care. This article reviews the literature with regard to diagnosis, treatment, and prevention. It provides conclusions that can be implemented in practice as well as an algorithm for the bedside clinician and also focuses on the controversies with regard to diagnostic tools and approaches, treatment plans, and prevention strategies.

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“…The use of kinetic beds in place of standard beds was found to decrease VAP incidence in some studies [120][121][122], but not in others [123][124][125][126][127][128][129]. In the recent meta-analysis by DELANEY et al [130], which included 1,169 patients from 15 trials, analysis of the 967 patients from the 10 studies that reported VAP rate [120][121][122][123][124][125][126][127][128][129] found that kinetic bed therapy reduced VAP incidence (odds ratio 0.38, 95% CI 0.28-0.53).…”

Section: Kinetic Bedsmentioning

confidence: 99%

“…In the recent meta-analysis by DELANEY et al [130], which included 1,169 patients from 15 trials, analysis of the 967 patients from the 10 studies that reported VAP rate [120][121][122][123][124][125][126][127][128][129] found that kinetic bed therapy reduced VAP incidence (odds ratio 0.38, 95% CI 0.28-0.53). However, kinetic bed therapy did not reduce mortality rate (odds ratio 0.96, 95% CI 0.66-1.14), duration of mechanical ventilation (pooled standardised mean difference -0.14 days, 95% CI -0.29-0.02 days), duration of intensive care unit stay (pooled standardised mean difference -0.064 days, 95% CI -0.21-0.086 days) or duration of hospital stay (pooled standardised mean difference 0.05 days, 95% CI -0.18-0.27 days).…”

Section: Kinetic Bedsmentioning

confidence: 99%