Keep the Head of Bed Elevated at Least 30 degrees for Intubated Patients if no Contraindications Exist
Deborah B. Hobson BSN
Sean M. Berenholtz MD, MHS
Mechanical ventilation is a common intervention in the intensive care unit (ICU). It places patients at an increased risk for death and complications, such as ventilator-associated pneumonia and gastrointestinal bleeding. Efforts to decrease the morbidity and mortality and improve the quality and safety of care for patients requiring mechanical ventilation are paramount. One simple no-cost intervention that improves outcomes in ventilated patients is to keep the head of the bed elevated ≥30 degrees. Elevating the head of bed ≥30 degrees can reduce the frequency and risk for nosocomial pneumonia compared with the supine position, decrease duration of mechanical ventilation, and decrease ICU length of stay. The evidence supporting this intervention is from a well-done randomized study of mechanically ventilated patients that found the incidence of pneumonia was reduced from 38% in the supine group to 8% in the ≥30-degrees group. Days on the ventilator and ICU length of stay were also reduced.