Chest physiotherapy for mechanically ventilated children: a survey of current UK practice

Shkurka, Emma; Wray, Jo; Peters, Mark; Shannon, Harriet

doi:10.1016/j.physio.2022.11.004

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…The study contributes valuable insights into the practice of chest physiotherapy in Karachi, yet it also underscores the need for continued research and standardization in the field to improve patient care (20,21).…”

Section: Discussionmentioning

confidence: 93%

Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Siddiqui,

Asif,

Sheikh

et al. 2023

JHRR

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Background: Despite the critical role of chest physiotherapy in the recovery process post open-heart surgery, there is a paucity of data on the practices of physical therapists in Karachi. With the high incidence of cardiovascular surgeries and the significant burden of postoperative complications, understanding current physiotherapy practices is essential for improving patient outcomes. Objective: The objective of this study was to evaluate the current practices of physical therapists regarding chest physiotherapy for patients undergoing open-heart surgery in Karachi and to identify potential areas for standardization and improvement. Methods: A cross-sectional study was conducted using a questionnaire survey among 40 physiotherapists working in cardiothoracic units across six major hospitals in Karachi. Participants were selected through non-probability convenient sampling, and data on preoperative and postoperative physiotherapy practices were collected. The survey included both open-ended and close-ended questions, with an emphasis on the types of treatments administered during the first five postoperative days. Statistical analysis was performed using SPSS version 25. Results: The mean age of the physiotherapists was 31.20 (SD = 6.8) years with an average working experience of 7.592 (SD = 6.7) years. On the day of surgery, physiotherapy was provided routinely by 7.5%, as needed by 62.5%, and was never provided by 30% of the respondents. From the first to the fifth postoperative day, routine physiotherapy was administered by an increasing majority, peaking at 100% on the second day. Written guidelines for the management of extubated and intubated patients were accessible to 35% and 10% of participants, respectively. Conclusion: There is a substantial engagement in chest physiotherapy post open-heart surgery among physiotherapists in Karachi. However, the variability in practice and the lack of standardized guidelines point towards a need for the development and implementation of standardized protocols to ensure consistent and evidence-based care.

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Section: Discussionmentioning

confidence: 93%

Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Siddiqui,

Asif,

Sheikh

et al. 2023

JHRR

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“…1 Studies have also found that ICPT can lower the incidence of pneumonia and lead to a shorter stay in the intensive care unit (ICU). [2][3][4][5] It is important to prevent extubation failure following a critical illness, as reintubation is associated with worse outcomes, longer hospitalization and higher rates of tracheotomies. 6,7 Severe deterioration, prolonged immobility and long-term mechanical ventilation are major risk factors for respiratory complications and muscle weakness in critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

“… 1 Studies have also found that ICPT can lower the incidence of pneumonia and lead to a shorter stay in the intensive care unit (ICU). 2 – 5 It is important to prevent extubation failure following a critical illness, as reintubation is associated with worse outcomes, longer hospitalization and higher rates of tracheotomies. 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Enhancing pulmonary function and arterial blood gas readings through immediate chest physiotherapy among extubated patients in ICU

Reshia,

Salameh,

Alsadaan

et al. 2023

J Int Med Res

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Objective To examine the effect of immediate chest physiotherapy (ICPT) on pulmonary function and arterial blood gases among extubated patients. Method This prospective study enrolled patients aged 20–60 years who had been intubated for 48 h. They were randomly assigned to either a control or study group. The study group received ICPT by trained critical care nurses and physiotherapists, which included early mobilization, breathing exercises and airway clearance. The control group received standard nursing chest care (positioning, oral and endotracheal suctioning) without ICPT. Researchers evaluated participants using pulmonary function tests, arterial blood gas tests and mechanical ventilation parameters. Results The study enrolled 70 patients. There were no significant differences in the sociodemographic characteristics and medical data before intubation between the two groups except for preparatory education. After extubation, the vital capacity was significantly higher in the study group compared with the control group. There were also significant differences between the two groups in other lung function tests and arterial blood gas tests. After extubation, the total lung capacity, functional residual capacity and residual volume were significantly higher in the study group compared with the control group. Conclusion The use of ICPT improved both pulmonary function and arterial blood gases.

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“…In addition, devices play an important role with options such as high-frequency chest wall oscillation (HFCWO) devices, positive expiratory pressure (PEP) devices, and intrapulmonary percussive ventilation (IPV). Inclusion of breathing exercises, such as deep breathing exercises and directed cough techniques, can also contribute to effective airway clearance 24,25. HFCWO devices use external forces, such as air pulses or mechanical vibrations, to loosen and mobilize mucus.…”

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confidence: 99%

Management of neurological problems in children on home invasive mechanical ventilation

Sayar,

Yıldırım,

Teber

2023

Pediatric Pulmonology

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IntroductionHome invasive mechanical ventilation (HIMV) has become a crucial long‐term respiratory support for children with neurological disorders, but requires advanced technological skills and 24‐h care. The increasing global population of children on HIMV is attributed to advancements in intensive care and improved survival rates.MethodThe manuscript will review the most common neurological problems encountered in children on HIMV.ConclusionThe manuscript emphasizes the multidisciplinary nature of managing these patients, involving pediatric pulmonologists, pediatric neurologists, pediatric intensivists, nurses, therapists, dietitians, psychologists, and caregivers. The manuscript outlines the challenges posed by neurological disorders, such as spinal muscular atrophy, muscular dystrophy, cerebral palsy, spinal cord injuries, and neurodegenerative disorders, which may result in respiratory muscle weakness and impaired ventilation. The importance of individualized assessments, appropriate ventilator mode and equipment selection, training of caregivers, airway clearance techniques, nutritional support, regular follow‐up visits, psychological and educational support, and addressing specific neurological issues such as involuntary movement disorders, prolonged seizures, sleep disorders, pain, sialorrhea, and immobilization‐related complications are discussed. The treatment options for these specific challenges are outlined. This review highlights the complex nature of managing children with neurological disorders on HIMV and the importance of a collaborative approach among healthcare professionals and caregivers to optimize care and improve the quality of life for these children.

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Chest physiotherapy for mechanically ventilated children: a survey of current UK practice

Cited by 5 publications

References 33 publications

Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Enhancing pulmonary function and arterial blood gas readings through immediate chest physiotherapy among extubated patients in ICU

Management of neurological problems in children on home invasive mechanical ventilation

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