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Continuous lateral rotational therapy in trauma-A systematic review and meta-analysis
Mark Schieren1, Florian Piekarski, Fabian Dusse
1From the University Witten/Herdecke, Medical Centre Cologne-Merheim, Department of Anaesthesiology and Intensive Care Medicine, Cologne, Germany.
The Journal of Trauma and Acute Care Surgery
|May 25, 2017
Summary
Continuous lateral rotational therapy (CLRT) significantly reduces pneumonia in trauma patients but does not impact mortality. Further research is needed to confirm its utility in preventing and treating pulmonary complications.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Trauma Surgery
Background:
- Trauma patients are at high risk for respiratory complications.
- Nosocomial pneumonia is a common and serious complication in critically ill trauma patients.
- Continuous lateral rotational therapy (CLRT) is a potential intervention to mitigate these risks.
Purpose of the Study:
- To evaluate the impact of CLRT on respiratory complications and mortality in trauma patients.
- To synthesize existing evidence through a systematic review and meta-analysis.
Main Methods:
- Systematic search of PubMed/Medline and Cochrane Library for prospective controlled trials.
- Inclusion of 8 publications (n=422 patients) in the meta-analysis.
- Comparison of CLRT with conventional manual positioning in trauma patients.
Main Results:
- CLRT significantly reduced the incidence of nosocomial pneumonia when used prophylactically (OR: 0.33, p=0.001).
- Therapeutic use of CLRT did not impact pneumonia rates.
- No significant differences were found in mortality, duration of mechanical ventilation, or ICU length of stay.
Conclusions:
- CLRT can reduce pneumonia rates in trauma patients, similar to other patient populations.
- The observed reduction in pneumonia did not translate to improved overall mortality.
- A well-designed, multi-center randomized controlled trial is necessary to definitively assess CLRT's utility.
