Takiguchi S A, Myers S A, Yu M, Levy M M, McNamara J J
Department of Surgery, Queen's Medical Center, Honolulu, HI 96813, USA.
Heart Lung. 1995 Jul-Aug;24(4):315-20. doi: 10.1016/s0147-9563(05)80076-7.
To determine the clinical impact and cost-effectiveness of two lateral rotation low air-loss therapy beds and their supporting protocols in the treatment of critically ill patients.
Retrospective-cohort (2:1 design) study consisting of chart reviews of patients on two types of lateral rotation low air-loss therapy and their protocols from January 1992 through July 1993.
Three intensive care units (ICUs) (30 medical and surgical beds) in a 506-bed community hospital.
Fifty-six critically ill patients admitted to the ICU and prescribed lateral rotation therapy. Patients treated on both beds were excluded from the study.
Data were collected on age, sex, Acute Physiology and Chronic Health Evaluation II score, Therapeutic Intervention Scoring System on admission to the ICU, and the time interval (number of days) from ICU admission until placement on a specialty bed (Lag Time). Outcome measurements included presence of pneumonia, adult respiratory distress syndrome, and multiorgan system dysfunction during the ICU stay, and the number of intubation days, ICU hours, hospital length of stay, and mortality during hospitalization.
Statistically significant differences in group outcomes were found as follows: (1) pneumonia (p = 0.001), (2) adult respiratory distress syndrome (p = 0.002), (3) hospital length of stay (p = 0.04), and (4) hospital costs (p = 0.0001).
In this study, patients treated by a prevention protocol with the Restcue beds (Support Systems International, Inc., Charleston, S.C.) had better clinical and financial outcomes than patients treated on Biodyne beds (Kinetic Concepts, Inc., San Antonio, Texas) with a more restricted, cost-conscious protocol aimed primarily at patients who have or who are at a higher risk for severe pneumonia, presence of septic shock, or adult respiratory distress syndrome.
确定两种侧旋低气耗治疗床及其配套方案在治疗重症患者中的临床效果和成本效益。
回顾性队列（2:1设计）研究，对1992年1月至1993年7月接受两种侧旋低气耗治疗及其方案的患者进行病历审查。
一家拥有506张床位的社区医院的三个重症监护病房（ICU）（30张内科和外科病床）。
56名入住ICU并接受侧旋治疗的重症患者。在两张床上均接受治疗的患者被排除在研究之外。
收集患者的年龄、性别、急性生理与慢性健康状况评估II评分、入住ICU时的治疗干预评分系统，以及从入住ICU到安置在专用床上的时间间隔（天数）（延迟时间）。结局指标包括在ICU住院期间肺炎、成人呼吸窘迫综合征和多器官系统功能障碍的发生情况，以及插管天数、ICU住院时长、住院时间和住院期间的死亡率。
发现两组结局存在统计学显著差异如下：（1）肺炎（p = 0.001），（2）成人呼吸窘迫综合征（p = 0.002），（3）住院时间（p = 0.04），以及（4）住院费用（p = 0.0001）。
在本研究中，采用Rescue床（国际支持系统公司，南卡罗来纳州查尔斯顿）的预防方案治疗的患者，其临床和经济结局优于采用Biodyne床（动力概念公司，得克萨斯州圣安东尼奥）治疗的患者，后者采用的是更严格、注重成本的方案，主要针对患有或有较高严重肺炎风险、存在感染性休克或成人呼吸窘迫综合征的患者。
