Automated rotational therapy for the prevention of respiratory complications during mechanical ventilation

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.