Trial reportIntensive care medicine2014
Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses.
Trial report in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Effect of various repositioning regimens on pressure wound ulcer occurrence in at-risk adult persons without existing pressure wound ulcers: A meta-analysis.International wound journal · 2023Pooled it
- Repositioning for pressure injury prevention in adults.The Cochrane database of systematic reviews · 2020Pooled it
- Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review.International wound journal · 2019Pooled it
- Turning and Repositioning Frequency to Prevent Hospital-Acquired Pressure Injuries Among Adult Patients: Systematic Review.Inquiry : a journal of medical care organization, provision and financingPooled it
- Joint Contracture Resulting From a Two-Hour Daily Joint Immobility: An Experimental Study in Rats.Cureus · 2026Article
- Pressure Injuries Related to the Positioning of Surgical Patients in the Operating Room and Identification of Associated Risk Factors: A Cross-Sectional Study.International wound journal · 2025Article
- Compliance with preventive measures recommended by an international study group for pressure injuries in adult critically ill patients.International wound journal · 2023Article
- Risk Factors for Pressure Injuries in Adult Patients: A Narrative Synthesis.International journal of environmental research and public health · 2022Review
- Is repositioning effective for pressure injury prevention in adults? A Cochrane Review summary with commentary.Turkish journal of physical medicine and rehabilitation · 2021Article
- International consensus on pressure injury preventative interventions by risk level for critically ill patients: A modified Delphi study.International wound journal · 2020Article
- Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: A scoping review.International wound journal · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe objective was to compare the effectiveness of repositioning every 2 or 4 h for preventing pressure ulcer development in patients in intensive care unit under mechanical ventilation (MV).
methodsThis was a pragmatic, open-label randomized clinical trial in consecutive patients on an alternating pressure air mattress (APAM) requiring invasive MV for at least 24 h in a university hospital in Spain. Eligible participants were randomly assigned to groups for repositioning every 2 (n = 165) or 4 (n = 164) h. The primary outcome was the incidence of a pressure ulcer of at least grade II during ICU stay.
resultsA pressure ulcer of at least grade II developed in 10.3% (17/165) of patients turned every 2 h versus 13.4% (22/164) of those turned every 4 h (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.46-1.71, P = 0.73). The composite end point of device-related adverse events was recorded in 47.9 versus 36.6% (HR 1.50, CI 95% 1.06-2.11, P = 0.02), unplanned extubation in 11.5 versus 6.7% (HR 1.77, 95% CI 0.84-3.75, P = 0. 13), and endotracheal tube obstruction in 36.4 versus 30.5%, respectively (HR 1.44, 95% CI 0.98-2.12, P = 0.065). The median (interquartile range) daily nursing workload for manual repositioning was 21 (14-27) versus 11 min/patient (8-15) (P < 0.001).
conclusionsA strategy aimed at increasing repositioning frequency (2 versus 4 h) in patients under MV and on an APAM did not reduce the incidence of pressure ulcers. However, it did increase device-related adverse events and daily nursing workload.
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