Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients.
BACKGROUND
When liver transplant candidates and recipients suffer from pulmonary complications of immobility, the results can be life-threatening. Continuous lateral rotation therapy has been reported to decrease complications of immobility.


OBJECTIVE
To determine whether continuous lateral rotation therapy decreases the duration of mechanical ventilation, intensive care unit length of stay, incidence or resolution of atelectasis, incidence or onset time of lower respiratory tract infection and pneumonia.


METHODS
Sixty-nine subjects admitted to a liver transplant intensive care unit at a university teaching hospital were randomly assigned to continuous lateral rotation therapy or a stationary bed. All subjects were mechanically ventilated for 24 hours and had a Glasgow Coma Scale score of 11 or less upon admission to the study. Subjects were followed until out of bed, unable to rotate for 3 consecutive days, or transferred from the intensive care unit. Data and chest roentgenogram results were collected on admission and daily during the study. Sputum culture results were obtained if available as part of normal patient care.


RESULTS
Incidence of lower respiratory tract infection was significantly lower and length of time to occurrence of lower respiratory tract infection was significantly longer in the continuous lateral rotation therapy group than in the stationary bed group.


CONCLUSIONS
Although continuous lateral rotation therapy did not affect duration of mechanical ventilation, length of stay, or incidence of atelectasis, it was effective in decreasing the incidence of, and increasing onset time to, lower respiratory tract infection in the liver transplantation population.
Whiteman
K
K
University of Pittsburgh Medical Center, Pa., USA.
Nachtmann
L
L
Kramer
D
D
Sereika
S
S
Bierman
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001510:Bed Rest / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000451:nursing; D016009:Chi-Square Distribution; D003422:Critical Care / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011014:Pneumonia / Q000517:prevention & control; D001261:Pulmonary Atelectasis / Q000517:prevention & control*; D012121:Respiration, Artificial; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D012399:Rotation; D013997:Time Factors