Response from the Authors:

We are delighted to read Dr. Pompeo's response to our article on pressure mapping for patients on continuous lateral rotation therapy (CLRT). It is gratifying to see a strong physician interest in patient positioning. This dialogue is exactly what we were hoping to generate. The purpose of our study was to analyze a common practice recommendation, which is not supported by research reported in the literature.

We understand how variable conditions, including patient condition, bed surface, length of time and placement of positioning devices, impact tissue response. In our limited study, we noted that regardless of rotation, with or without pillows, there was pressure on the bony prominences. The implication is that pillows may be inadequate repositioning devices.

We also know that pressure mapping will not measure effects of shearing, which typically present long after a patient is removed from CLRT. The significance of the relationship between shear effect and CLRT has been conjectured, but there is a dearth of research related to this.

The results of our study further raised an important question about whether the pulmonary benefits of CLRT are compromised when pillows are used for patient positioning.

We are pleased to learn that Dr. Pompeo shares our interest in supplemental positioning and has mapped mattress systems. We would enjoy the opportunity to read his results in future WOCN journals and continue this vital discussion.

Patricia G. Turpin, RN, PhD, CNAA, BC

Valerie Pemberton, RN, BSN, CWOCN