Following tracheal intubation, mucus flow is reversed in the semirecumbent position: possible role in the pathogenesis of ventilator-associated pneumonia

Bassi G, Zanella A, Cressoni M, Stylianou M

As ICU patients are typically nursed in a semi-recumbent position, this study chose to look at the effects of gravitational force on mucus transport and bacteria colonisation of the respiratory system. This was an animal study, carried out on 16 health sheep.

Spontaneously breathing or ventilated sheep were randomly assigned to one of two groups; trachea position above horizontal and below horizontal.

Results showed that following intubation, pneumonia was found in 6/8 of the 'trachea-up' sheep but in none of the 'trachea down' sheep.  More research is required before definite conclusions can be drawn, but this study has the potential to question how ICU patients are best positioned.

Critical Care Medicine, 2008, 36(2), 518-25

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