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Administrators: Critical Care Therapies™: FAQ: FAQs: RotoProne® Therapy System
FAQs: RotoProne® Therapy System
The RotoProne® Therapy System can help improve patient outcomes by delivering the benefits of Prone Therapy along with Kinetic Therapy™ in an easier-to-use automated system. Touch-screen controls, automated CPR and digital therapy meters are just a few of the features available.
 
 

Easy-To-Use, Clinically Proven Therapies in an Automated System
What therapies does the RotoProne® Therapy System provide?
  • Kinetic Therapy™ – The continuous rotation of patient from side-to-side to a minimum of 40° and up to 62°. The patient can be rotated unilaterally or bilaterally.
  • Prone Therapy – Placing the patient in the face down position.
  • RotoProne® Therapy - Placing the patient in the face down position, while simultaneously rotating the patient from side-to-side to a minimum of 40° and up to 62°. The patient can be rotated unilaterally or bilaterally.
What are the benefits of using Kinetic Therapy™?
Studies have shown that Kinetic Therapy™ can help:
  • Reduce ICU-acquired pneumonia by up to 50%1
  • Reduce ICU length of stay by up to 24%1
  • Reduce ventilation time by up to 42%2
What are the benefits of using Prone Therapy?
Studies have shown that placing patients in the prone position may help:
  • Facilitate drainage of pulmonary secretions3
  • Decrease pleural pressures in the dependent portions of the lungs4
  • Eliminate compression of the lungs by the heart5
  • Improve ventilation and perfusion matching6
In clinical research, use of Prone Therapy has shown positive clinical results such as:
  • 17% shorter ventilation time7
  • 26% shorter ICU length of stay7
  • Lower VAP incidence in patients with acute respiratory failure8

What are the Prone Therapy and RotoProne® Therapy Guidelines for Use?
The Guidelines for Use are based on clinical studies, evidence-based research and best practices in ICUs with extensive experience in prone positioning of critically ill patients.  Click here to download this reference source for clinicians.

Can Kinetic Therapy™ help reduce costs in preventing pulmonary complications?
A study found an average cost savings of $6,695 per patient associated with Kinetic Therapy™ in the reduction of lower respiratory tract infections.9

Can the RotoProne® Therapy System be used for patients with unstable spinal cord injuries?
No. The RotoProne® Therapy System is contraindicated for unstable cervical, thoracic and lumbar fractures as well as cervical traction and/or skeletal traction.  The KCI RotoRest® Delta can be used to provide Kinetic Therapy™ for patients with unstable spinal cord injuries.

What is ARDS?
Acute Respiratory Distress Syndrome (ARDS) is a devastating inflammatory disease of the lung characterized by the sudden onset of pulmonary edema and respiratory failure, usually in the setting of other acute medical conditions resulting from direct or indirect injury.10  Patient mortality associated with ARDS has been estimated between 32% and 45%.11   

How can I manage patient lines and tubes while utilizing the RotoProne® Therapy System?
The RotoProne® Therapy System has a unique tube management system designed to help minimize binding, disconnecting and dislodging of tubing during rotation and movement between prone and supine positions.  The accessory rack at the foot end of the system can hold chest drainage units, foley bags, etc.

How many nurses are required to prone the patient with the RotoProne® Therapy System?
Once the patient is transferred to the RotoProne® Therapy System and appropriately secured, one nurse can rotate the patient from the supine position to the prone position using the hand control located at the head of the system.

If the patient has a problem while in the prone position, how quickly can the RotoProne® Therapy System turn the patient back to the supine position?
There are three options that will allow you to bring the patient back to the supine position; two automated and one manual.  The two automatic options are easily visible and will, with the touch of one button, bring the patient back to the supine position within 40 seconds.  There is a manual emergency release lever as well that can be used to manually bring the patient back to supine (which should be used only in emergencies when the automated options are not available or quicker access is needed).  

How long should the patient remain prone/supine and to what degree of turn?
This is a decision that should be made by the physician, noting the patient’s hemodynamics with rotation as well as the patient’s current medical condition and history.  KCI recommends 3.25 hours in the prone position combined with rotation at 40-62° to each side and 45 minutes in the supine position for nursing care, assessment and resolution of dependent edema.  This is only a guideline.  Each patient's individual needs and tolerances must be assessed and therapy applied accordingly. 

Is it also necessary to rotate in the prone position?
No.  If rotation is not utilized, the patient may be a candidate for proning on the KCI TriaDyne® II Therapy System utilizing the Proning Accessory Kit.  The RotoProne® Therapy System patient surface is not designed for long-term stationary use.  Static positioning in either the prone or supine position could increase the risk of patient skin breakdown.  The gradual gentle rotation of the RotoProne® Therapy System helps to constantly shift pressure in any one location of the patient’s body.  For this reason, the RotoProne® Therapy System has a safety alarm, which will alert the caregiver every 30 minutes if the patient is not rotating.  If rotation is not to be a part of the patient’s treatment, the RotoProne® Therapy System is not recommended.
 
Can I use a percussion vest on my patients while they are on the RotoProne® Therapy System?  
Yes, however, use caution to avoid excess pressure from the vest or any wires.  Always perform periodic pressure point checks and skin assessment to help minimize risks of skin breakdown.

Can I use a cooling blanket on my patients while they are on the RotoProne® Therapy System?
Yes, either a cooling blanket or a warming blanket may be used by your patients while on the RotoProne® Therapy System.  Skin assessments should be done more frequently to monitor for potential skin breakdown.

How do I secure the endotracheal tube (ETT) before proning?
The weight of the connector mechanism between the ETT and the ventilator tubing may be taped or secured with trach ties to the facemask.  Be sure the ETT is securely taped to the patient prior to proning.  The ventilator tubing is then routed through the tube management system to minimize tangling.

1 Choi SC, Nelson LD, Kinetic Therapy™ in Critically Ill Patients: Combined Results Based on Meta-Analysis. Journal of Critical Care, 1992; 7:57-62
2 Fink MP, Helsmoortel, CM, The Efficacy of an Oscillating Bed in the Prevention of Lower Respiratory Tract Infection in Critically Ill Victims of blunt Trauma. Chest, 1992; Vol. 97, 132-137
3 Pelosi, P., BrazziL., Gattinoni L. Prone Position in the Acute Respiratory Distress Syndrome. European Respiratory Journal. 2002 Oct; 20 (4): 1017-28
4 Mutoh T, Guest RJ, Lamm W, Albert RK,. Prone Position Alters the Effect of Volume Overload on Regional Pleural Pressures and Improves Hypoxemia in Pigs in Vivo. Am. Rev. Respir. Dis. 1992; 146:330-336
5 Albert R, Hubmayr R. The Prone Position Eliminates Compression on the Lungs by the Heart. American Journal Respiratory Critical Care Medicine, 2000; 161: 1660-1665
6 Pappert D, Rossaint R, Slama K et al. Influence of Positioning on Ventilation – Perfusion Relationships in Severe Adult Respiratory Distress Syndrome. Chest, 1994; 106: 1511-1516
7 Watanabe, I, et al, Beneficial Effect of a Prone Position for Patients with Hypoxemia after Transthoracic Esophagectomy, Critical Care Medicine, 2002; 30(8): 1799-1802
8 Guerin, C, et al, Effect of a Systematic Prone Positioning in Hypoxemia Acute Respiratory Failure: A Randomized Controlled Trial, JAMA, 2004; 292(19): 2379-2387
9 Mullins, C, PhD, et al. Cost Effectiveness of Kinetic Therapy™ in Preventing Nosocomial Lower Respiratory Tract Infections in Patients Suffering from Trauma, Managed Care Interface, August 2002; 15: 35-40. Results based on a single study. Individual cost savings may vary.
10 http://www.ardsnet.org/, Frequently Asked Questions
11 Gattinoni L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V, Malacrida R, Di Giulio P, Fumagalli R, Pelosi P, Brazzi L, Latini R, Effect of Prone Position on the Survival of Patients with Acute Respiratory Failure, The New England Journal of Medicine, Vol. 345, No. 8, August 23, 2001

Note: The KCI Products described in this section have indications, contraindications, warnings, precautions and safety information.  Please consult a physician and applicable product Instructions for Use prior to operation and use.