The Impact of Continuous Lateral Rotation Therapy in Overall Clinical and Financial Outcomes of Critically Ill Patients

Abstract

Continuous lateral rotation therapy, when introduced early in course of treatment of high-risk patients, reduces critical care LOS and cost to treat.

Continuous Lateral Rotation Therapy

“…McKay 6 suggested that CLRTs achieve the best outcomes when implemented within 24 to 48 hours of meeting set criteria and are maintained for at least 18 hours per day. SwadenerCulpepper et al 8 reported that CLRT patients in an early intervention group (implemented within 48 hours of meeting criteria) fared much better on the outcome criteria evaluated than did the late intervention group (CLRT implemented more than 48 hours after criteria were met). Therefore, early identification of patients who could benefit from therapy has the best potential for improving outcomes.…”

“…If rotation is stopped at all, it should be stopped only for long enough to deal with the underlying cause of the instability. 8 Evaluation of the patient's oxygen levels, respiratory rate, ventilator settings, arterial blood gas levels, and other parameters may reveal the need for interventions in other areas that would minimize desaturation during rotation. Decreasing the time and depth of rotation to the side where the greatest desaturation occurs can improve tolerance as well.…”

“…Over the years, numerous studies have been performed to examine the effectiveness of CLRT. Many studies [2][3][4][5][6][7][8] have shown improvement in various pulmonary outcome indicators when lateral rotation therapies were implemented.…”

“…[2][3][4][5][6][7][8] Some patients have not tolerated CLRT because of the continuous motion of the bed. [2][3][4][5][6][7][8] Published data are not sufficient to support recommendations for increasing sedation to promote patients' tolerance of rotation, nor have reports been published on outcomes in patients with whom lateral rotation was not implemented because the patient was agitated. However, evaluation of each clinical situation is necessary to determine the risk/benefit of CLRT.…”

Tips for Protecting Critically Ill Patients From Pressure Ulcers

“…It is appropriate to use pillows and other positioning devices during the 6 hours of non-CLRT therapy. [5][6][7][8][9][10][11] …”