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Chest physiotherapy effectiveness to reduce hospitalization and mechanical ventilation length of stay, pulmonary infection rate and mortality in ICU patients.

Abstract

INTRODUCTION
Although physiotherapy is an integral part of the multiprofessional team in most ICUs there is only limited evidence concerning the effectiveness of its procedures. The objectives of this study were to verify if physiotherapy care provided within 24 h/day for hospitalized patients in the ICU reduce the length of stay, mechanical ventilation support, pulmonary infection and mortality compared to a physiotherapy care provided within 6 h/day.
METHODS
A cohort study was designed to assess differences between one hospital where patients were given physiotherapy care for 24 h/day and another hospital with only 6 h/day. We considered the following as outcome measurements: clinical diagnosis, medication in use, presence of associated diseases, APACHE II and SOFA scores, ICU and mechanical ventilation length of stay, development of pulmonary infections and survival.
RESULTS
One hundred and forty-six patients were enrolled. Patients admitted in the service A presented a lower length of stay in mechanical ventilation (p < 0.0001), ICU stay (p = 0.0003), respiratory infections (p = 0.0043) than patients admitted in service B. No difference was found for APACHE II score (p = 0.8) and SOFA scores (p = 0.2) between groups. The mortality risk was OR 1.3 (1.01-2.33) (p = 0.04) for patients in the service B.
CONCLUSION
The presence of a physiotherapist in the intensive care unit contributes decisively to the early recovery of the patient, reducing mechanical ventilation support need, number of hospitalization days, incidence of respiratory infection and risk of mortality.

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  • Publisher Full Text
  • Authors

    Castro AA, Calil SR, Freitas SA, Oliveira AB, Porto EF

    Institution

    Physical Therapy Department of the Adventist University (Unasp), São Paulo, Brazil. antonioamcastro@yahoo.com.br

    Source

    Respiratory medicine 107:1 2013 Jan pg 68-74

    MeSH

    Adult
    Aged
    Brazil
    Female
    Hospital Mortality
    Hospitalization
    Humans
    Intensive Care
    Intensive Care Units
    Length of Stay
    Male
    Middle Aged
    Physical Therapy Modalities
    Pneumonia
    Respiration, Artificial
    Respiratory Therapy
    Time Factors

    Pub Type(s)

    Evaluation Studies
    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    23085215