Chest physiotherapy with early mobilization may improve extubation outcome in critically ill patients in the intensive care units
Journal
Clinical Respiratory Journal
Journal Volume
12
Journal Issue
11
Pages
2613-2621
Date Issued
2018
Author(s)
Abstract
Background: Extubation failure can lead to a longer intensive care unit (ICU) stay, higher mortality rate, and higher risk of requiring tracheostomy. Chest physiotherapy (CPT) can help patients in reducing the accumulation of airway secretion, preventing collapsed lung, improving lung compliance, and reducing comorbidities. Much research has investigated the correlation between CPT and respiratory system clearance. However, few studies have investigated the correlation between CPT and failed ventilator extubation. Therefore, this study aimed to investigate the use of CPT for reducing the rate of failed removal from mechanical ventilators. Methods: This study was an intervention study with mechanical control. Subjects were divided into two groups. The control group, which received routine nursing chest care, was selected from a retrospective chart review. The intervention group was prospectively taken into the chest physiotherapy program. The chest physiotherapy treatment protocol consisted of inspiratory muscle training, manual hyperinflation, chest wall mobilization, secretion removal, cough function training, and early mobilization. Results: A total of 439 subjects were enrolled in the intervention and control groups, with a mean age of 69?years. APACHE II score (P?=.09) and GCS scores (P =.54) were similar between the two groups. Compared to the control group, patients in the intervention group had a significantly lower reintubation rate (8% vs 16%; P =.01). Conclusions: The results indicate that intensive chest physiotherapy could decrease extubation failure in mechanically ventilated patients in the ICU. In addition, chest physiotherapy could also significantly improve the rapid shallow breathing index score. ? 2018 John Wiley & Sons Ltd
Subjects
chest physiotherapy; critical care; early mobilization; extubation failure; intensive care unit; mechanical ventilation; rapid shallow breathing index; reintubation
SDGs
Other Subjects
aged; APACHE; Article; artificial ventilation; breathing exercise; clinical protocol; controlled study; critically ill patient; device removal; extubation; female; health program; human; hyperinflation; intensive care unit; intervention study; length of stay; major clinical study; male; mobilization; muscle training; outcome assessment; patient care; priority journal; prospective study; retrospective study; ventilated patient; very elderly; classification; comparative study; critical illness; endotracheal intubation; extubation; intensive care unit; mechanical ventilator; middle aged; mobilization; mortality; nursing; outcome assessment; physiotherapy; procedures; respiratory care; standards; statistics and numerical data; tracheostomy; trends; ventilator weaning; Aged; Aged, 80 and over; Airway Extubation; APACHE; Critical Illness; Early Ambulation; Female; Humans; Intensive Care Units; Intubation, Intratracheal; Male; Middle Aged; Mortality; Outcome Assessment (Health Care); Physical Therapy Modalities; Prospective Studies; Respiratory Therapy; Retrospective Studies; Tracheostomy; Ventilator Weaning; Ventilators, Mechanical
Publisher
Blackwell Publishing Ltd
Type
journal article