[Lateralization as alternative to static prone decubitus in patients with ARDS]

Enferm Intensiva. 2006 Jan-Mar;17(1):12-8. doi: 10.1016/s1130-2399(06)73909-8.
[Article in Spanish]

Abstract

According to Phillips, Continuous Lateral Rotation (CLR) or Kinetic Therapy (KT) together with the technological advances obtain some important benefits in mechanically ventilated patients.

Objective: Compare Static Prone Decubitus (PD) with DP in CRL.

Patients and methods: We analyzed 2 groups with a total of 41 patients in the period of January 1998 to April 2003. The DP group (25 patients) remained static and the lateral group (16 patients) in CLR every 2 h. The groups had 56 +/- 16 vs 64 +/- 17 years, 77 +/- 20 vs 71 +/- 23 kg and 24% vs 31% of survival, respectively.

Results: We maintained the PD 37 +/- 30 vs 27 +/- 36 h for group 1 and 2. The response as Responders is 68% and 69%. pO2/FiO2 of supine pre-DP to supine post-DP is 79 +/- 21 to 146 +/- 68 versus 80 +/- 20 to 138 +/- 57 and pulmonary compliance 22 +/- 10 to 21 +/- 10 vs 31 +/- 10 to 32 +/- 9. Mean blood pressure of S to S was 87 +/- 16 to 85 +/- 15 vs 82 +/- 10 to 80 +/- 9, and mean Heart rate 108 +/- 21 to 95 +/- 24 vs 85 +/- 32 to 75 +/- 28. Complications by groups were: facial edema of 84% vs 63%, gastric retention 36% to 38%, vomiting/regurgitation 12% to 0%, epistaxis 8% to 31%. Pressure Sore (PS) Incidence decreased from 36% to 12%, together with seriousness.

Conclusion: We consider that lateralization if PD is a technique comparable to static PD on the respiratory and hemodynamics level. CLR in PD may prevent some complications.

Publication types

  • Comparative Study

MeSH terms

  • Case-Control Studies
  • Female
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Physical Therapy Modalities
  • Posture
  • Respiratory Distress Syndrome / nursing*