[Acute pulmonary and cardiovascular effects of continuous axial rotation (kinetic therapy) in respiratory failure].
OBJECTIVE
Continuous lateral rotational therapy (kinetic therapy) is advocated to improve pulmonary gas exchange in patients with severe respiratory failure, by promoting mobilization of secretions and reducing mismatch of ventilation and perfusion. We analyzed the acute pulmonary and hemodynamic changes before and after beginning kinetic therapy in critically ill patients with inotropic support.


METHODS
Due to severe respiratory failure, 18 patients with "systemic inflammatory response syndrome" had been placed in a kinetic bed (Rotorest, KCI Mediscus). Retrospective analysis included several indices of arterial oxygenation, intrapulmonary "shunt fraction", cardiac index, arterial and pulmonary arterial pressure, systemic vascular resistance and systemic oxygen consumption.


RESULTS
After the start of kinetic therapy, we found a statistically significant improvement of pulmonary gas exchange and a reduction of shunt fraction 12 hours later. Cardiac index and arterial and pulmonary arterial pressure remained unchanged. Systemic oxygen consumption was increased.


CONCLUSIONS
The continuous axial rotation of patients with severe respiratory failure results in a prompt improvement of arterial oxygenation. Even in hemodynamically unstable patients we did not observe harmful effects.
Bein
T
T
Klinik für Anästhesiologie, Universität Regensburg.
Metz
C
C
Eberl
P
P
Pfeifer
M
M
Taeger
K
K
D000328:Adult; D000368:Aged; D001513:Beds; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D026741:Physical Therapy Modalities / Q000295:instrumentation / Q000379:methods*; D011659:Pulmonary Gas Exchange; D011669:Pulmonary Wedge Pressure; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D014655:Vascular Resistance
Akute pulmonale und kardiovaskuläre Effekte der kontinuierlichen axialen Rotation (Kinetische Therapie) beim Lungenversagen.