Outcome of Physical Therapy Intervention on Ventilator Weaning and Functional Status
Article Outline
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.
Key Words: mobility , physical therapy , respiratory care center , weaning from ventilator
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References
- . Insurance BoNH . Available at http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10238&class_no=440&level_no=1 [Date accessed: August 02, 2009]
- Functional status and quality of life in ventilator-dependent patients . Formos J Phys Ther . 2004;29:40–47
- . The nursing experience of uncertainty in a patient with respiratory failure during weaning mechanical ventilation . Chang Gung Nurs . 2003;14:199–206
- . The nursing care of a patient with acute pulmonary edema weaning successfully from ventilator . Tzu Chi Nurs J . 2005;4:86–95
- Investigation of physical therapy utilization in integrated delivery system among patients with long-term mechanical ventilation . Formos J Phys Ther . 2006;31:39–45
- . Early physiotherapy in the respiratory intensive care unit . Respir Med . 2005;99:1096–1104
- . Functional evaluation: The Barthel Index . Md State Med J . 1965;14:61–65
- . A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation . N Engl J Med . 1991;324:1445–1450
- . Effect of respiratory muscle performance on ventilatory weaning . Thorac Med . 2005;20:371–379
- . The art and science of predicting patient readiness for weaning from mechanical ventilation . Int J Nurs Stud . 2000;37:145–151
- The efficacy of physical therapy in patients with long-term mechanical ventilation . Formos J Phys Ther . 2004;31:39–45
- Supported arm training in patients recently weaned from mechanical ventilation . Chest . 2005;128:2511
- . Effects of inspiratory muscle training on weaning in ventilator-dependent patients . Formos J Med . 2006;10:586–594
- Respiratory weakness is associated with limb weakness and delayed weaning in critical illness . Crit Care Med . 2007;35:2007–2015
- Case report: inspiratory muscle training in chronic critically ill patients – a report of two cases . Physiother Res Int . 2005;10:222–226
- . Inspiratory muscle training to enhance weaning from mechanical ventilation . Anaesth Intensive Care . 2007;25:776–779
- Pulmonary Rehabiliation: Joint ACCP/AACVPR Evidence-based clinical practice guidelines . Chest . 2007;131:S4–42
PII: S1607-551X(10)70060-7
doi:10.1016/S1607-551X(10)70060-7
© 2010 Elsevier. Published by Elsevier Inc. All rights reserved.
