Keywords

continuous lateral rotation therapy, critical care, kinetic therapy, motion therapy, nursing, pulmonary outcomes

Authors

1. Swadener-Culpepper, Leslie MSN, RN, CCRN, CCNS
2. Skaggs, Rita L. RN
3. VanGilder, Catherine A. BS, MT, CCRA

Abstract

Background: Significant pulmonary complications are prevalent in intubated and mechanically ventilated patients.

Objectives: This study was conducted to determine the impact of continuous lateral rotation therapy (CLRT) on patients considered to be at high risk for pulmonary complications. Overall study objectives included hospital length of stay, critical care length of stay, ventilator days, and cost to treat.

Methods: Patients at risk for pulmonary complications as defined by Pao₂/Fio₂ ratio < 300, Fio₂ > 50% for more than 1 hour, positive end-expiratory pressure >= 8, or a Predicus score of >= 5 were compared with a historical comparison group that met the high-risk criteria given above and did not receive CLRT. Patients who received CLRT were separated into 2 groups, early CLRT group (began therapy within 48 hours, n = 49) or late CLRT group (n = 46).

Results: The early CLRT group had a reduction in critical care LOS, (P = .04) as compared with the non-CLRT group. Total hospital costs were reduced (P = .01) in the early intervention group compared to the late intervention group, as well as ICU LOS (P = .02). Nonsignificant trends were seen in reduced ventilator days and hospital LOS. Reintubation rates and readmissions to critical care were also lower in the early intervention group.

Conclusions: Continuous lateral rotation therapy, when introduced early in course of treatment of high-risk patients, reduces critical care LOS and cost to treat.