Web site designed and maintained by Chris Cairns  © SICS EBM Group 2004                                  

Do kinetic beds prevent nosocomial pneumonia?

Citation: Fink MP, et al. The efficacy of an oscillating bed in the prevention of lower respiratory tract infection in critically ill victims of blunt trauma: a prospective study. Chest 1990; 97:132-137.
 

Lead author's name: Fink MP

Three-part Clinical Question:

Patients: trauma patients in a surgical ICU for > 24h

Intervention: rotating bed v. conventional bed

Outcome: incidence of pneumonia – both community and hospital acquired
 

Search Terms: Intensive care, critical care, mechanical ventilation, ventilator-associated pneumonia, nosocomial pneumonia, prevention, controlled trial

The Study: Partially blinded, randomised trial with intention-to-treat analysis.
 

The Study Patients: 106 blunt trauma patients in a surgical ICU. 7 patients were excluded from analysis because of a stay of < 24h
 

Control group N = 48; all analysed
 

Experimental group N = 51; all analysed, even though 13 were not given treatment because of objecting orthopaedic surgeons.

The Evidence:

Comments:
Blunt trauma victims were randomised to the treatment groups and were all followed up. Criteria for diagnosis of pneumonia used simple clinical, lab and radiological data. The radiologists were the only people blinded to treatment groups. Both community and hospital –acquired pneumonias would have been included in outcomes.

By chance, there were more major head trauma victims in the control group. The incidence of smokers in the two groups was not stated.

No power calculation was done.

The poor validity of this study and its lack of generalisation to all intensive care patients caution against the adoption of this therapy.

Appraised by: David Swann, Consultant, ICU, Edinburgh Royal Infirmary.
 

Email: d.g.swann@ed.ac.uk

Kill or Update By: December 2009

Printer Friendly Version 

© SICS EBM Group 2004