Journal of Palliative Care & Medicine
Open Access

Abstract

Continuous Lateral Rotation Therapy (CLRT) is a treatment modality used in intensive care units for early mobilization of ventilated patients by mechanically rotating them laterally left-center-right in bed. Research supports its use for the treatment of pulmonary diseases and for the prevention of VAP by mobilizing secretions in the lungs. Some in healthcare believe that CLRT is not sufficient to allow for capillary re-perfusion, which may lead to tissue damage. The purpose of this research is to evaluate the effect of CLRT on posterior skin integrity by asking the following questions: Are there differences in skin pressure readings, skin integrity, or perceived discomfort among three positioning scenarios: Continuous lateral rotation therapy (CLRT) only; CLRT with static wedge (30�°) and static wedge (30�°). A linear mixed model analysis for repeated measures was used to compare mean and maximum interface pressure. Maximum pressures were recorded to quantify the amount of pressure on capillary beds while mean pressures were recorded to illustrate a pressure over time effect. CLRT alone demonstrated statistically lower interface pressures on ischial tuberosities (P<0.05) as compared to any use of a static wedge. Statistically higher pressures were noted on the heels in CLRT alone (P<0.05). No difference noted between static wedge alone and CLRT with wedge. Pain noted in wedge positioning: 7/10 subjects; CLRT with wedge: 6/10 subjects; CLRT alone: 1/10 subjects. No erythema or breakdown noted. The results of this study support the use of CLRT to decrease pressure on capillary beds and also decrease patient pain.

Biography

Email: robert-anderson@uiowa.edu