Choi, SC; Nelson, LD. Kinetic Therapy In Critically Ill Patients: Combined Results Based On Meta-Analysis.
Journal of Critical Care, March 1992.
This meta-analysis of 419 patients concluded that when 40 degree or more of Kinetic Therapy is initiated within 24 hours of admission and used for ten days, the results are a 24% reduction in ICU stay, a 35% reduction in hours intubated and a 50% reduction in ICU-acquired pneumonia.

Raoof, Suhail, MD, FCCP; et al. Effect of Combined Kinetic Therapy and Percussion Therapy on the Resolution of Atelectasis in Critically Ill Patients.
CHEST, 1999; 115; 1658—1666.
This prospective and randomized study measured the effect of Kinetic Therapy (>40 degree to each side) combined with mechanical percussion in the resolution of established atelectasis of the lungs and hypoxemia in critically ill, hospitalized patients. Partial or complete resolution of atelectasis was seen in 82.3% of the test group, as compared to 14.3% of the control group. Bronchoscopy was performed in 43% of the control group, but in none of the patients in the test group. Also, an improvement in oxygenation index occurred in the test group (Pa02/Fi02) at the end of therapy, while the control group showed a reduction over a similar duration of time.

Traver, GA; et al. Continuous Oscillation: Outcome In Critically Ill Patients.
Poster presented at the 1993 ALA/ATS International Conference, San Francisco, CA.
This randomized, prospective study compared the use of a continuous oscillation bed to traditional two hour turning. The study demonstrated that when patients were mechanically rotated to 24 degrees on a specialty bed, there was no statistically significant difference between the continuous oscillation bed group and the standard bed group.

Whiteman, K; et al. Effects of Continuous Lateral Rotation Therapy On Pulmonary Complications In Liver Transplant Patients.
American Journal of Critical Care, March 1995; 4:133—139.
This randomized prospective study revealed no significant differences in the length of mechanical ventilation and ICU stay between patients turned to 30 degrees and those patients placed on stationary beds.

Dolovich, M; et al. Effect of Kinetic Therapy On Lung Mucous Transport In Mechanically Ventilated Patients.
Journal of Critical Care, September 1998.
This study shows that 30-degree lateral rotation does not appear to stimulate mucous clearance over a four-hour period.

We have outlined and referenced many clinical studies that answer the question, “Why repositioning your patients is so important.” Lateral positioning can prevent the adverse effects of prolonged bed rest, such as formation of decubitus ulcers and atelectasis(25-27), improve oxygenation in patients with unilateral lung disease(30-31), and decrease length of stay in the intensive care unit and occurrence of complications such as fever and atelectasis in patients after cardiac surgery.(31-32)

Laterally repositioning a patient allows the skin to recover from pressure. Changing your patient’s position frequently relieves pressure, which if unrelieved, is the most common cause of pressure ulcers.

Laterally repositioning also forces gravity to assist the drainage of pulmonary secretions from the smaller bronchial airways into the main bronchi and trachea. This enables the patient to cough up these secretions. Remember that the Degree of Turn plays a critical role in the treatment and prevention of pulmonary complications.