The impact of continuous lateral rotation therapy in overall clinical and financial outcomes of critically ill patients.
BACKGROUND
Significant pulmonary complications are prevalent in intubated and mechanically ventilated patients.


OBJECTIVE
This study was conducted to determine the impact of continuous lateral rotation therapy (CLRT) on patients considered to be at high risk for pulmonary complications. Overall study objectives included hospital length of stay, critical care length of stay, ventilator days, and cost to treat.


METHODS
Patients at risk for pulmonary complications as defined by Pao2/Fio2 ratio < 300, Fio2 > 50% for more than 1 hour, positive end-expiratory pressure > or = 8, or a Predicus score of > or = 5 were compared with a historical comparison group that met the high-risk criteria given above and did not receive CLRT. Patients who received CLRT were separated into 2 groups, early CLRT group (began therapy within 48 hours, n = 49) or late CLRT group (n = 46).


RESULTS
The early CLRT group had a reduction in critical care LOS, (P = .04) as compared with the non-CLRT group. Total hospital costs were reduced (P = .01) in the early intervention group compared to the late intervention group, as well as ICU LOS (P = .02). Nonsignificant trends were seen in reduced ventilator days and hospital LOS. Reintubation rates and readmissions to critical care were also lower in the early intervention group.


CONCLUSIONS
Continuous lateral rotation therapy, when introduced early in course of treatment of high-risk patients, reduces critical care LOS and cost to treat.
The Medical Center of Central Georgia, Macon, GA, USA. culpepper.leslie@mccg.org
Leslie
L
Swadener-Culpepper
Rita L
RL
Skaggs
Catherine A
CA
Vangilder
D018806:APACHE; D001510:Bed Rest / Q000009:adverse effects / Q000451:nursing; D001513:Beds; D015400:Clinical Nursing Research; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics / Q000379:methods*; D016638:Critical Illness / Q000191:economics / Q000451:nursing*; D004434:Early Ambulation; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D015915:Motion Therapy, Continuous Passive; D024802:Nurse's Role; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D018579:Patient Selection; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012399:Rotation; D013997:Time Factors