We tested the hypothesis that the incidence of LRTI in critically ill blunt trauma victims can be reduced by employing continuous postural oscillation. Within 24 h of admission to the SICU, 106 patients were prospectively randomized to either a conventional bed or a RRKTT. Seven patients who were discharged from the SICU in less than 24 h were excluded from the data analyses. Until discharge from the SICU, patients were monitored daily for development of LRTI or pneumonia. Among 48 patients in the control group, 28 met criteria for LRTI and 19 met criteria for pneumonia. Among 51 patients in the RRKTT group, 13 developed LRTI and 7 developed pneumonia. The differences between groups for all LRTI and pneumonia were both significant. We conclude that continuous postural oscillation decreases the risk of pulmonary sepsis in victims of major blunt trauma.