Intensive care unit (ICU) patients on respirators are at high risk for preventable pulmonary complications (PPC). Turning these patients from side to side may reduce PPC, but carries the burden of decreases in blood pressure and oxygenation. The investigators hypothesize that there will be no difference in PPC or adverse events when ICU patients on respirators are turned by nurses or by an automated turning bed.
The purpose of this pilot study is to test the feasibility of two turning protocols and study procedures for a multi-site randomized clinical trial to evaluate efficacy and safety of horizontal positioning interventions to reduce pulmonary complications in mechanically ventilated critically ill adult patients. The hypothesis of the randomized controlled trial (RCT) is no difference in pulmonary complications between manual, 2-hourly lateral rotation to \> 45 degrees (control), and continuous automated turning to 45 degrees (experimental) groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
16
Manual turn from side to back to side every 2 hours by nurses while patient receiving mechanical ventilation
Continuous, automated turning to a maximum of 45 degrees in the lateral positions while the patient is receiving mechanical ventilation
Incidence of Pulmonary Complications.
Number of participants who did not have preventable pulmonary complications (PPC) on pre-study chest radiograph (CXR) and developed PPC during the study period. Pearson Chi-Square test used to test significance of difference between turning groups.
Time frame: Participants were followed for the duration of ICU stay, an average of 10 days.
Mechanical Ventilation Duration.
Days on mechanical ventilation, from initiation to withdrawal of mechanical ventilation
Time frame: Participants were followed for the duration of mechanical ventilation, an average of 5.5 days.
ICU Length of Stay.
Time in days from study ICU admission to study ICU discharge or death
Time frame: Participants were followed for the duration of ICU stay, an average of 10 days.
ICU All-cause Mortality.
Death from any reason between admission and discharge from study ICU
Time frame: Participants were followed for the duration of ICU stay, an average of 10 days.
Turning-related Events
Non-serious adverse events that occurred during the time of rotation in the kinetic therapy bed group and during lateral rotation to right or left position in the manual turn group
Time frame: Participants were followed for the duration of time on protocol, an average of 3.5 days.
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