Eur Respir J 2001; 18:1079-1080
Copyright ©ERS Journals Ltd 2001
From the Authors
A. Torres on behalf of the members of the European Task Force on VAP
Servei de Pneumologia, Institut Clinic de Pneumologia i Cirurgia Toracica, Villarroel 170, 08036, Barcelona, Spain
From the authors:
Thank you very much for your interest in the recently published European Task Force on ventilator-associated pneumonia (VAP) 1. You are right in your statement that rotational beds were not mentioned in the section concerning prevention. In fact I recently had the opportunity to review this issue, in depth, for the next Consensus Conference on intensive care unit acquired pneumonia to be held in Chicago, next September. The efficacy of this preventive measure, has been investigated in a model of ventilated baboons by Anzueto et al. 2 with positive results. I have found six randomized studies 3–8 in which rotational therapy was compared to standard therapy for the prevention of VAP. In most of these studies there was a decreased incidence of VAP with rotational therapy. Although the populations studied were very heterogeneous, if you total all the patients investigated the figure obtained is 
400 patients which is something to be taken into account.
I agree with you that this subject deserved to be included in the section "What should be investigated in prevention" and I apologize for this omission. This issue should be investigated in a randomized fashion using a multicentre approach. Since the cost of the beds is very high a meticulous study on cost-effectiveness should also be carried out.
References
- Torres A, Carlet J. on behalf of The European Task Force Comittee on VAP. Ventilator-associated pneumonia. Eur Respir J 2001;17:1034–1045.[Free Full Text]
- Anzueto A, Peters J, Seidner S, Cox W, Schroeder W, Coalson J. Effects of continuous bed rotation and prolonged mechanical ventilation on healthy, adult baboons. Crit Care Med 1997;25:1560–1564.[CrossRef][ISI][Medline]
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- Gentilello L, Thompson A, Tonnessen AS, et al. Effect of rotational bed therapy on the incidence of pulmonary complications in critically ill patients. Crit Care Med 1988;16:783–786.[ISI][Medline]
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- Kelley RE, Vibulsreth S, Bell L, Duncan RC. Evaluation of kinetic therapy in the prevention of complications of prolonged bed rest secondary to stroke. Stroke 1987;18:638–642.[Abstract/Free Full Text]
- Fink PM, Helsmoortel CM, Stein KL, Lee PC, Cohn SM. The efficacy of an oscillating bed in the prevention of lower respiratory tract infections in critically ill victims of blunt trauma. Chest 1990;97:132–137.[Abstract/Free Full Text]
- Summer WR, Curry P, Haponik EF, Nelson S, Elston T. Continuous mechanical turning of intensive care unit patients shortens length of stay in some diagnostic-related groups. J Crit Care 1989;4:45–53.
- De Boisblanc BP, Castro M, Everret B, et al. Effect of air-supported, continuous, postural oscillation on the risk of early ICU pneumonia in nontraumatic critical illness. Chest 1993;103:1543–1547.[Abstract/Free Full Text]
- Whiteman K, Natchman L, Kramer D, Sereika S, Bierman M. Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant recipients. Am J Crit Care 1995;4:133–139.
