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Continuous lateral rotation therapy to prevent ventilator-associated pneumonia
Thomas Staudinger1, Andja Bojic, Ulrike Holzinger
1Department of Internal Medicine I, Intensive Care Unit, Medical University of Vienna, Vienna, Austria. thomas.staudinger@meduniwien.ac.at
Critical Care Medicine
|October 1, 2009
Summary
Continuous lateral rotation therapy significantly reduced ventilator-associated pneumonia (VAP) in critically ill patients. This therapy also shortened mechanical ventilation duration and hospital length of stay, offering a feasible preventive measure.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Infectious Diseases
Background:
- Ventilator-associated pneumonia (VAP) is a significant complication in critically ill patients requiring mechanical ventilation.
- Effective preventive strategies are crucial to reduce VAP incidence, duration of ventilation, and hospital length of stay.
Purpose of the Study:
- To evaluate the impact of continuous lateral rotation therapy (CLRT) on VAP prevalence in mechanically ventilated medical patients.
- To assess the effect of CLRT on duration of mechanical ventilation, intensive care unit (ICU) length of stay, and mortality.
Main Methods:
- A prospective, randomized clinical study was conducted in three university hospital medical ICUs.
- Patients requiring mechanical ventilation for less than 48 hours and free from pneumonia were randomized to CLRT or standard care.
- VAP diagnosis was confirmed by chest radiograph, purulent secretions, and microbiological confirmation.
Main Results:
- VAP frequency was significantly lower in the CLRT group (11%) compared to the control group (23%) (p = .048).
- Duration of mechanical ventilation (8 vs. 14 days, p = .02) and ICU length of stay (25 vs. 39 days, p = .01) were significantly shorter with CLRT.
- Mortality rates were comparable between the groups; however, 39% of patients in the CLRT group experienced intolerance.
Conclusions:
- Continuous lateral rotation therapy effectively reduces the prevalence of ventilator-associated pneumonia in critically ill patients.
- CLRT is associated with shorter mechanical ventilation duration and hospital length of stay.
- CLRT should be considered as an additive preventive measure for ventilated patients at risk of VAP.
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