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Loren D. Nelson, MD; Hans B. Anderson, RRT

Arch Surg. 1989;124(3):352-355.

Abstract
• Ten hemodynamically stable patients requiring mechanical ventilation for radiographically symmetric acute lung disease were studied during steep lateral positioning and continuous rotation in a Roto Rest kinetic treatment bed. There were no significant hemodynamic or ventilatory differences among the four positions (supine, right side down, left side down, and rotating). In four patients, arterial oxygen pressure (Pao₂) decreased 16% to 49% in the lateral position when compared with the supine position. Continuous rotation restored the Pao₂ toward the supine value in each patient. In six patients, Pao₂ increased 11% to 35% during lateral positioning. In five of the six patients, the increase in Pao₂ differed between sides, suggesting asymmetric lung disease. Continuous rotation did not significantly alter the Pao₂ from the supine values in these patients. Adverse effects on oxygenation caused by positional changes may be reversed by continuous rotation using the Roto Rest kinetic bed.

(Arch Surg 1989;124:352-355)

Author Affiliations
From the Department of Surgery, University of Miami, and the Surgical Intensive Care Unit, Jackson Memorial Medical Center, Miami. Dr Nelson is now with the Section of Surgical Sciences, Vanderbilt University School of Medicine, Nashville, Tenn.

Footnotes
Accepted for publication Dec 3, 1987.

Reprint requests to St Thomas Hospital, PO Box 380, 4220 Harding Rd, Nashville, TN 37202 (Dr Nelson).

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