Clinical and financial outcomes of lateral rotation low air-loss therapy in patients in the intensive care unit

Objective To determine the clinical impact and cost-effectiveness of two lateral rotation low air-loss therapy beds and their supporting protocols in the treatment of critically ill patients. Retrospective-cohort (2:1 design) study consisting of chart reviews of patients on two types of lateral rotation low air-loss therapy and their protocols from January 1992 through July 1993. g Three intensive care units (ICUs) (30 medical and surgical beds) in a 506-bed community hospital. ts Fifty-six critically ill patients admitted to the ICU and prescribed lateral rotation therapy. Patients treated on both beds were excluded from the study. ements Data were collected on age, sex, Acute Physiology and Chronic Health Evaluation II score, Therapeutic Intervention Scoring System on admission to the ICU, and the time interval (number of days) from ICU admission until placement on a specialty bed (Lag Time). Outcome measurements included presence of pneumonia, adult respiratory distress syndrome, and multiorgan system dysfunction during the ICU stay, and the number of intubation days, ICU hours, hospital length of stay, and mortality during hospitalization. s Statistically significant differences in group outcomes were found as follows: (1) pneumonia (p=0.001), (2) adult respiratory distress syndrome (p=0.002), (3) hospital length of stay (p=0.04), and (4) hospital costs (p=0.0001). sions In this study, patients treated by a prevention protocol with the Restcue beds (Support Systems International, Inc., Charleston, S.C.) had better clinical and financial outcomes than patients treated on Biodyne beds (Kinetic Concepts, Inc., San Antonio, Texas) with a more restricted, cost-conscious protocol aimed primarily at patients who have or who are at a higher risk for severe pneumonia, presence of septic shock, or adult respiratory distress syndrome.