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Do kinetic beds prevent nosocomial pneumonia?

Citation: Whiteman K , et al. Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients. Am J Crit Care. 1995 Mar; 4(2):133-9.

Lead author's name: Whiteman K

Three-part Clinical Question:

Patients: selected patients in a liver ICU

Intervention: rotating 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: 69 ICU patients with acute liver failure
 

Control group N = 36; all analysed
 

Experimental group N = 33; all analysed

The Evidence:

Comments:

Patients admitted to a liver ICU who were still ventilated after 24h were randomised.

Patients in the study groups seem similar.

Patients were followed up until mobilisation. The diagnosis of pneumonia was based on a combination of clinical, radiological and microbiological findings. 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 lack of effect may be because of the small sample size, but there is no support for this intervention.

Appraised by: David Swann, Consultant, ICU, Royal Infirmary of Edinburgh.
Email: d.g.swann@ed.ac.uk

Kill or Update By: December 2009

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