After-hours respiratory physiotherapy for intubated and mechanically ventilated patients with community-acquired pneumonia: An Australian perspective.

Lee, Lisa van der; Hill, Anne‐Marie; Patman, Shane

doi:10.1016/j.aucc.2017.10.001

Cited by 7 publications

(2 citation statements)

References 27 publications

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“…There is variability in the provision of after-hours cardiopulmonary physical therapy (care provided after normal work hours, e.g., 5 PM-8 AM, which may include variations of late shifts, overnight shifts, and/or on-call), with 79% in the United Kingdom; 0% in Germany, Portugal, and Sweden; and 47% in Australia, of acute hospitals having an after-hours service. 5,16,17 Guidelines and standards are just evolving for the educational profile and scope of practice requirements for physical therapy within ICUs in Australia, Japan, Nigeria, Singapore, the United Kingdom, and South Africa. [18][19][20][21][22][23][24] However, it is unclear whether hospital physical therapy or critical care departments utilize these guidelines.…”

Section: Introductionmentioning

confidence: 99%

International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19

Ntoumenopoulos,

Patman

2023

Cardiopulm Phys Ther J

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Objectives: The aim of this study was to report on the cardiorespiratory assessments, interventions, and outcome measures used by physical therapists with critically ill patients and the impact of COVID-19. Design: An anonymous international online survey of practice (through Google Forms) of physical therapists was conducted. Setting: The study was conducted in adult intensive care units. Participants: A total of 309 physical therapists participated in the study. Interventions: A survey was used to determine current cardiopulmonary physical therapy practices in ICU. Results: Predominantly participants were female (74%), aged 31 to 40 years (40%), having worked in intensive care unit (ICU) for either 0 to 5 years (38%) or 11 to 20 years (28%), and worked full time (72%). Most participants worked in the United Kingdom (36%), Europe (21%), or Australia/Oceania (18%). The 3 most frequently reported assessment indicators for cardiopulmonary physical therapy interventions were lobar collapse/atelectasis, audible secretions, and decreased/added lung auscultation sounds. The 3 most commonly used outcome measures included lung auscultation, arterial blood gas analysis, and transcutaneous arterial saturation. The 3 most commonly used physical therapy interventions (“very often” in a descending order) included patient mobilization, repositioning to optimize gas exchange, and endotracheal suctioning. For the COVID-19 cohort, participants reported similar use of patient repositioning to optimize gas exchange and postural drainage, and lower use of patient mobilization and endotracheal suctioning, deep breathing exercises, active cycle of breathing technique, and oropharyngeal suctioning. Conclusion: This survey reports on the characteristics of physical therapists who work in ICU, and their cardiopulmonary physical therapy assessments, interventions, and outcome measures most commonly used, inclusive of patients with COVID-19. There were some differences in interventions provided to the COVID-19 cohort compared with the non–COVID-19 cohort.

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Section: Introductionmentioning

confidence: 99%

International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19

Ntoumenopoulos,

Patman

2023

Cardiopulm Phys Ther J

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“…A survey of clinical practice of senior physiotherapists working in Australian ICUs found that physiotherapists commonly provide respiratory physiotherapy interventions during daytime working hours for ventilated patients with CAP, comprising specific positioning to target the affected lung regions, hyperinflation techniques, manual chest wall techniques, and airway suctioning. 15 , 17 These interventions are aimed at improving alveolar ventilation and secretion clearance to optimize pulmonary function and physical recovery and enhance weaning from mechanical ventilation. 15 Despite being considered an essential component of usual care for this ICU patient cohort, 18 , 19 there is limited evidence regarding the efficacy of respiratory physiotherapy for patients who require invasive ventilation in ICU for pneumonia.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of physiotherapy management for patients with pneumonia requiring invasive ventilation in a single-center Australian ICU

Kwan

Hill

Elliott

et al. 2022

Hong Kong Physiother. J.

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Background: Pneumonia is a frequent diagnosis for patients admitted to Australian intensive care units (ICUs) for invasive ventilation. Physiotherapists in ICU provide interventions to enhance respiratory function and physical recovery. Objective: This retrospective cohort study aimed to describe physiotherapy management of adults with pneumonia who require invasive mechanical ventilation in a single Level 3 ICU in a quaternary teaching hospital. Methods: All adults admitted with a medical diagnosis of pneumonia requiring invasive mechanical ventilation over a two-year period were included. Demographic and clinical data, including APACHE II score, ventilator-free days (VFDs) to day 28, ICU length of stay (LOS), and type and frequency of physiotherapy episodes of care delivered in ICU, were collected from electronic medical records. Correlations between VFDs to day 28 and the frequency of physiotherapy interventions delivered per subject were examined using Spearman’s rho analysis. Results: From 208 records screened, 66 subjects with an ICU admission diagnosis of pneumonia, who required invasive mechanical ventilation, were included. Median (IQR) ICU LOS was 10 (5–17) days, and mortality rate was 15.2% ([Formula: see text]). The cohort had a median of 20.5 (IQR 2–25) VFDs to day 28. Community-acquired pneumonia (66.7%, [Formula: see text]) was the most frequent type of pneumonia diagnosis. There were 1110 episodes of physiotherapy care, with patients receiving a median of 13.5 (IQR 6.8–21.3) episodes during their ICU stay, with a median rate of 1.2 (IQR 1.0–1.6) episodes per day. Over 96.7% of patients with pneumonia received physiotherapy treatment during their ICU stay. Overall, physiotherapy treatments consisting only of respiratory techniques were most commonly provided (55.1%, [Formula: see text]). Airway suctioning (92.4%, [Formula: see text]), patient positioning (72.7%, [Formula: see text]) or positioning advice to nurses (77.3%, [Formula: see text]), and hyperinflation techniques (63.6%, [Formula: see text]) were among the respiratory techniques most delivered. Conclusion: This study described the current intensive care physiotherapy management in a single center for adults with pneumonia who required invasive mechanical ventilation, demonstrating that respiratory physiotherapy interventions are often provided for this ICU patient cohort. Further research is warranted to determine the efficacy of respiratory physiotherapy interventions to justify their use for ICU patients with pneumonia receiving invasive mechanical ventilation.

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Defining minimum workforce standards for intensive care physiotherapy in Australia and New Zealand: A Dephi study

Thomas,

Chaseling,

Marais

et al. 2024

Australian Critical Care

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After-hours respiratory physiotherapy for intubated and mechanically ventilated patients with community-acquired pneumonia: An Australian perspective.

Abstract: Further research is required to determine whether the frequency of respiratory physiotherapy intervention, including after-hours provision of treatment, influences outcomes for ICU patients intubated with pneumonia.

Cited by 7 publications

References 27 publications

International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19

International Survey of Cardiopulmonary Physical Therapy Management of Adult Intensive Care Unit Patients and the Impact of COVID-19

A retrospective study of physiotherapy management for patients with pneumonia requiring invasive ventilation in a single-center Australian ICU

Defining minimum workforce standards for intensive care physiotherapy in Australia and New Zealand: A Dephi study

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