Results Fifteen patients were enrolled; 11 completed both
days. Patients were maintained at 30º (mean, 30º) for 96% of
minutes and at 45º (mean, 39º) for 77% of minutes. No patients
showed signs of pressure ulcers. A total of 188 oral secretions
were obtained, 82 (44%) were pepsin-positive; 174 tracheal
secretions were obtained, 108 (62%) were pepsin-positive. The
median percentage of pepsin-positive oral secretions was not
significantly higher (P = .11) at 30º elevation (54%) than at 45º
elevation (20%). The median percentage of pepsin-positive
tracheal secretions was not significantly higher (P = .37) at
30º elevation (71%) than 45º elevation (67%). Deeper sedation
correlated with increased reflux (P = .03).