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

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.

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.

CONCLUSIONS

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.