Evid Based Nurs 9:117 doi:10.1136/ebn.9.4.117
  • Treatment

A target backrest elevation of 45° was not feasible for mechanically ventilated patients; elevations achieved did not prevent ventilator associated pneumonia

 Q In critically ill patients on mechanical ventilation, is a semirecumbent position of 45° feasible and effective for prevention of ventilator associated pneumonia (VAP)?



randomised controlled trial.




blinded (outcome assessors).

GraphicFollow up period:

median 5–6 days (range 0–64 d).


4 intensive care units (ICUs) in 3 university hospitals in the Netherlands.


221 adults (mean age 64 y, 63% men) who were intubated within 24 hours of ICU admission and had an expected duration of ventilation ⩾48 hours.


semirecumbent position (backrest 45° from horizontal) (n = 112) or supine position (10°) (n = 109) for the duration of ventilation. A nurse adjusted the backrest of the bed to the allocated position 2–3 times daily, but it could be changed at patient request or as required for care.


microbiologically confirmed VAP, pressure …

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