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

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

Author Castro, Antônio Adolfo Mattos de Autor UNIFESP Google Scholar
Calil, Suleima Ramos Google Scholar
Freitas, Susi Andrea Google Scholar
Oliveira, Alexandre B. Google Scholar
Porto, Elias Ferreira Autor UNIFESP Google Scholar
Institution Adventist Univ Unasp
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Fed Univ Pampa Unipampa
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. (c) 2012 Elsevier B.V. All rights reserved.
Keywords Chest physiotherapy
Hospital stay
Weaning
Pulmonary infection
Mortality
Intensive care unit patients
Language English
Date 2013-01-01
Published in Respiratory Medicine. London: W B Saunders Co Ltd, v. 107, n. 1, p. 68-74, 2013.
ISSN 0954-6111 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 68-74
Origin http://dx.doi.org/10.1016/j.rmed.2012.09.016
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000314135600008
URI http://repositorio.unifesp.br/handle/11600/35655

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