CONTINUOUS OSCILLATION - OUTCOME IN CRITICALLY ILL PATIENTS

Purpose: To compare turning by an oscillating bed to standard 2-hour t urning. Outcomes were survival, length of stay (LOS), duration of mech anical ventilation, and incidence of pneumonia. Methods: One hundred a nd three intensive care patients were randomly assigned to standard tu rning or turning by an oscillating bed. Data, collected at baseline, d aily for 7 days, and then three times weekly until study discharge, in cluded demographics, initial Acute Physiology and Chronic Health Evalu ation (APACHE II) score, ventilatory/gas exchange parameters, indica t ors of pneumonia, nursing measures, and chest roentgenograph. Results: There were no significant differences for LOS, duration of ventilatio n, nor incidence of pneumonia. Higher survival for subjects on the osc illating bed reached borderline significance (P = .056) for subjects w ith APACHE II greater than or equal to 20. Longitudinal data were anal yzed using the random effects model. No differences in ventilatory or gas exchange parameters were identified. Among subjects who developed pneumonia there was a significantly higher respiratory score (nursing acuity scale) for subjects on the oscillating bed. Conclusions: In sel ected critically ill patients oscillating therapy may improve survival and improve airway clearance. The frequency and degree of turning nee ded to prevent complications and improve outcome remains unclear. Thes e newer beds should be used with discrimination so as to not increase hospital costs unnecessarily. Copyright (C) 1995 by W.B. Saunders Comp any