Kinetic beds are designed to prevent pulmonary complications, including atelectasis. The objective of this study was to determine the effect of kinetic beds on the incidence of atelectasis in mechanically ventilated patients.
50 kinetic beds, 20 Rotation modules and 20 Percussion modules were introduced to the Westchester Medical Center on July 26, 2001. A retrospective chart review of all mechanically ventilated patients at this tertiary-care medical center who underwent bronchoscopy for atelectasis was conducted for 2 separate periods. The first was for the period immediately preceding the arrival of these beds i.e. July 2000 to June 2001. The second period was from July 2002 to June 2003 which allowed a year to pass after the introduction of these beds in order for healthcare personnel to become aware of their presence and potential benefits.
Of the 3399 ICU admissions between July 2000 and July 2001, 71 patients developed atelectasis while being mechanically ventilated. Of the 3065 ICU admissions between July 2002 and June 2003, 83 patients developed atelectasis. There was no significant difference in the hospital and ICU length of stay, ventilator utilization by the hospital and the Case-mix Index between these 2 periods.
There was no decrease in the incidence of atelectasis in mechanically ventilated patients at our institution after the introduction of these kinetic beds despite their widespread availability.
Most studies have shown kinetic beds to be potentially beneficial. However, all these studies were performed under a strict protocol to ensure appropriate usage. Our institution did have a protocol but did not require a physician’s order, thereby ensuring that usage was almost entirely dependent on nursing personnel. The fact that our study showed no reduction in the incidence of atelectasis after the introduction of these beds is probably related to their underutilization and not to their lack of efficacy. To obtain a benefit from such an expensive investment, institutions should consider physician orders as a means of ensuring appropriate utilization of these beds.
Rachna Sahityani, None.