Continuous lateral rotation therapy for acute hypoxemic respiratory failure: the effect of timing

Previous studies have indicated a positive impact of continuous lateral rotational therapy on nosocomial pneumonia, but have shown mixed results in decreasing length of stay or ventilator days. The objective of the study was to determine if the use of a continuous lateral rotational therapy protocol would decrease mortality and morbidity, mean ventilator days, and/or intensive care unit and hospital length of stay in patients with a pulmonary diagnosis. The study also analyzed the effect of the lag time to the initiation of therapy. Prospectively enrolled subjects receiving continuous lateral rotational therapy based on predetermined indications were compared with retrospectively identified control subjects who met the same inclusion criteria from a similar time period in the previous year. Early initiation of continuous lateral rotational therapy resulted in significant decreases in ventilator days and intensive care unit length of stay. The therapeutic benefit of continuous lateral rotational therapy may be enhanced with early identification and treatment of appropriate patients.