Outcome of Physical Therapy Intervention on Ventilator Weaning and Functional Status
Received 18 September 2009; accepted 28 December 2009.
Our study aimed to understand the characteristics of ventilator dependence in patients at a respiratory care center and the potential effects of physical therapy on ventilator weaning and patients' functional status. Prospective data collection consisted of the following: (1) demographic data, including name, gender, age, diagnosis, the Acute Physiology and Chronic Health Evaluation as a severity of the disease, modified Glasgow Coma Scale, mobility at the time of admission, and days of hospitalization; (2) Rapid shallow breathing index (RSBI) as a predictive indicator of ventilator weaning, including indicators of ventilator weaning were collected from the respiratory flow sheet; and (3) Barthel index. Between July 1 and December 31, 2007, 126 patients were admitted to the respiratory care center, and those who required mechanical ventilation for more than 14 days were enrolled. Fifty-five subjects received physical therapy. The RSBI in patients who received physical therapy was 75.7 ± 37.9 before therapy and 80.0 ± 48.5 afterwards, while the Barthel index increased from 0.8 ± 1.4 to 1.9 ± 2.5 (p < 0.05). The RSBI decreased as time of physical therapy lengthened, but not significantly (r = 0.12, p = 0.44). The success rate of ventilator weaning in patients receiving physical therapy intervention versus non-physical therapy intervention was 58.2% and 40.9%, respectively. The results indicated that lengthening the physical therapy intervention time enhanced the ventilator weaning success rate while mobility was not affected (r = −0.11, p = 0.41). Physical therapy may be offered to ventilator-dependent patients in line with their individual needs to improve or maintain basic mobility.
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aDepartment of Nursing, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
bDivision of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
cDepartment of Rehabilitation, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
dFaculty of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Address correspondence and reprint requests to: Ms I-Chun Chuang, Faculty of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan