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Do kinetic beds prevent nosocomial pneumonia?
Lead author's name: Gayle Traver
Three-part Clinical Question: Patients: selected patients in a general ICU Intervention: oscillating 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: partly blinded,
randomised, intention-to-treat analysis. The Study Patients: 103 ICU
patients Control group N = 59; all
analysed Experimental group N = 44; all analysed
The Evidence:
Comments: Patients admitted to two general ICUs were randomised if a kinetic bed was available. Extensive exclusion criteria limit the generalisability of the study. Patients in the study groups seem similar. Patients were followed up until mobilisation. The diagnosis of pneumonia was based on presence of purulent sputum + chest X-ray changes + fever/raised WBC. No bacteriological study was done. The radiologist was blinded to the treatment group. Both community-acquired and nosocomial pneumonias would have been included as outcomes. No power calculation was done. The poor design of this study
prevents inclusion in a robust meta-analysis.
Kill or Update By: December 2009
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