The Efficacy of an Oscillating Bed in the Prevention of Lower Respiratory Tract Infection
Tnfectious complications are an important cause of morbidity and late mortality after major trauma. Lower respiratory tract infections, ie, pneumonia and tracheobronchitis, occur commonly in critically ill victims of head trauma, thoracic trauma, spinal cord trauma and other severe injuries. The increased risk of LRTI in these patients is almost certainly a consequence of multiple factors, including systemic alterations in immune competence, impaired mucociliary clearance in the tracheobronchial tree, pulmonary edema secondary to direct injury to the lung, diffuse lung injury (ie, adult respiratory distress syndrome), and gastric alkalinization with antacids and/or H2-antagonists.
An additional contributory factor may be immobilization. Many years ago, it was recognized that prolonged recumbency increases the risk of pulmonary complications after operation. For this reason, early ambulation following surgery (when feasible) is standard practice. Unfortunately, early ambulation is typically impossible in critically ill victims of major trauma. Oscillating beds, however, may offer a way to avoid some of the adverse effects of prolonged immobilization. In the present study, we tested the hypothesis that the incidence of LRTI in victims of nonpenetrating trauma can be reduced by employing an oscillating bed. levitra professional
