Abstract
Physiotherapists are integral members of the multidisciplinary team managing critically
ill adult patients. However, the scope and role of physiotherapists vary widely internationally,
with physiotherapists in some countries moving away from providing early and proactive
respiratory care in the intensive care unit (ICU) and focusing more on early mobilization
and rehabilitation. This article provides an update of cardiorespiratory physiotherapy
for patients receiving mechanical ventilation in ICU. Common and some more novel assessment
tools and treatment options are described, along with the mechanisms of action of
the treatment options and the evidence and physiology underpinning them. The aim is
not only to summarize the current state of cardiorespiratory physiotherapy but also
to provide information that will also hopefully help support clinicians to deliver
personalized and optimal patient care, based on the patient's unique needs and guided
by accurate interpretation of assessment findings and the current evidence. Cardiorespiratory
physiotherapy plays an essential role in optimizing secretion clearance, gas exchange,
lung recruitment, and aiding with weaning from mechanical ventilation in ICU. The
physiotherapists' skill set and scope is likely to be further optimized and utilized
in the future as the evidence base continues to grow and they get more and more integrated
into the ICU multidisciplinary team, leading to improved short- and long-term patient
outcomes.
Keywords
assessment - cardiorespiratory physiotherapy - intensive care - mechanical ventilation
- treatment
