Semirecumbency among mechanically ventilated ICU patients: a multicenter observational study

Background: Preventing major morbid events such as ventilator associated pneumonia (VAP) is integral to the care of critically ill patients. Nursing patients in the semirecumbent instead of supine position is associated with lower rates of aspiration and VAP. Objective: To observe the frequency of semirecumbency amongst mechanically ventilated patients in the intensive care unit (ICU). Design: Prospective multicenter observational study. Population: Patients who were mechanically ventilated for >48 hours in four Canadian university-affiliated ICUs. Measurements: At the same time each day for 5 consecutive days, we recorded the body position of ventilated patients and categorized them into four groups: less than 15 degrees from the horizontal, 15-30 degrees, 31-45 degrees, and greater than 45 degrees. To avoid the Hawthorne effect, ICU team members were unaware of the study hypothesis. Results: We observed 61 patients age 59.3 (7.8) years, 29 (48%) female. We recorded body position for 164 patient-venti...