Continuous lateral rotational therapy in trauma-A systematic review and meta-analysis
| Autor: | Frank Wappler, Marcel Poels, Florian Piekarski, Mark Schieren, Hanke Marcus, Jerome Defosse, Fabian Dusse |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment MEDLINE Critical Care and Intensive Care Medicine Patient Positioning law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Continuous lateral rotational therapy Medicine Humans 030212 general & internal medicine Mechanical ventilation Cross Infection business.industry Incidence (epidemiology) Pneumonia Ventilator-Associated 030208 emergency & critical care medicine Evidence-based medicine Pneumonia Length of Stay medicine.disease Meta-analysis Emergency medicine Wounds and Injuries Surgery business |
| Zdroj: | The journal of trauma and acute care surgery. 83(5) |
| ISSN: | 2163-0763 |
| Popis: | Background The purpose of this study was to evaluate the impact of continuous lateral rotational therapy (CLRT) on respiratory complications and mortality in patients suffering from trauma. Methods The literature databases PubMed®/Medline® and the Cochrane Library® were systematically searched for prospective controlled trials comparing continuous lateral rotational therapy to conventional manual positioning in trauma patients. Results A total of 8 publications (n= 422 patients) with comparable age and injury severity were included in the meta-analysis. A significant reduction in the incidence of nosocomial pneumonia (OR: 0.33, [95%CI: 0.17, 0.65], p=0.001) was observed in patients treated prophylactically with continuous lateral rotational therapy. When used with therapeutic intention, CLRT had no impact on the incidence of pneumonia. There were no significant differences in mortality, duration of mechanical ventilation, or ICU length of stay. Conclusions Analogous to studies evaluating CLRT in medical or mixed patient collectives, CLRT reduced the rates of nosocomial pneumonia in trauma patients. This, however, had no impact on overall mortality. The level of evidence of the studies included was limited by several factors. An adequately powered, well-designed multi-centre randomised controlled trial is required, to validly assess the utility of CLRT for the prevention and treatment of pulmonary complications in patients suffering from trauma. Level of evidence Systematic review and meta-analysis, level III. |
| Databáze: | OpenAIRE |
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