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Semin Respir Crit Care Med 2022; 43(03): 390-404
DOI: 10.1055/s-0042-1744307
Review Article

An Update on Cardiorespiratory Physiotherapy during Mechanical Ventilation

Oystein Tronstad
1   Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Australia
2   Physiotherapy Department, The Prince Charles Hospital, Brisbane, Australia
,
Joan-Daniel Martí
3   Cardiac Surgery Critical Care Unit, Institut Clinic Cardiovascular, Hospital Clínic, Barcelona, Spain
4   Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
,
George Ntoumenopoulos
5   Department of Physiotherapy, St. Vincent's Hospital, Sydney, Australia
,
Rik Gosselink
6   Department Rehabilitation Sciences, University of Leuven, University Hospitals Leuven, Belgium
› Author Affiliations
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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


Publication History

Article published online:
22 April 2022

© 2022. Thieme. All rights reserved.

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