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Title: Effect Of Multimodality Chest Physiotherapy On The Rate Of Recovery And Prevention Of Complications In Patients With Mechanical Ventilation A Prospective Study In Medical And Surgical Intensive Care Units
Researcher: Renu B. Pattanshetty
Guide(s): Gaude, Gajanan S
Keywords: chest vibrations
manual hyperinflation
mechanical ventilation
multimodality chest physiotherapy
positioning complications, outcome
University: KLE University
Completed Date: 01/04/2011
Abstract: Background: Patients receiving mechanical ventilation have an increased risk of complications besides an increased risk of sputum retentions leading to ventilation weaning more difficult and resulting in excess morbidity and mortality. Various chest physiotherapy techniques play an important role in management of ventilated patients. The chest physiotherapy techniques adopted have been studied on patients as a single entity or with combination of two techniques. Objectives: The present study was designed to evaluate the effect of multimodality chest physiotherapy on rate of recovery and prevention of complications in ventilated patients. Material and methods: A total of 220 patients were referred for chest physiotherapy, out of which 20 patients were excluded since they did not meet the inclusion criteria. 200 patients were randomly allocated to each of the two groups with 100 patients in study group and 100 in control group respectively. MH and suctioning was administered to 86 patients in the control group and suctioning + MH + chest vibrations and positioning to 87 patients in the study group, respectively, till they were extubated. Both the groups received chest physiotherapy treatment twice daily. Standard care in the form of routine nursing care, pharmacological therapy as advised by concerned physician/surgeon was strictly implemented throughout the intervention period. 13 patients from the study group and 14 from the control group withdrew from the study during the study period. All the patients were followed up for the global outcomes in terms of successful weaning, recovery and discharge from hospital, death, total length of stay on ventilation and complications encountered during mechanical ventilation XX Results: Data of 173 adult intubated and ventilated patients who participated in the study were subjected to statistical analysis using SPSS windows version 13.0. The study demonstrated significant improvements with multimodality chest physiotherapy treatment in terms of rate of recovery with 66.7% patients in study group compared to 32.6% of patients in control group (p=0.000). Complication rates were higher with 61.6% in the control group as compared to 26.4% complications in the study group. VAP was observed in 32 patients in the study group as compared to 38 patients in the control group. The physiotherapist based protocol was helpful in significant reduction of complications. Only 26.4% of patients suffered from complications in the study group as compared to 61.6% in the control group (p=0.000). Duration of hospitalization was longer in the study group (16±9.40 days) as compared to the control group (12.8±6.12 days). Successful weaning from mechanical ventilation was noted in 58 patients in study and 24 patients in control group. Conclusion: Multi modality chest physiotherapy protocol has shown to prevent ventilator associated pneumonia and enhance the clinical outcome in adult ventilated patients and may be recommended as a treatment option in ICU. This therapist based protocol has also enhanced the weaning process and has proved to be safe with no advent of adverse events and may be used as a routine chest physiotherapy treatment in adult intubated and ventilated patients. newline
Pagination: 199 p.
Appears in Departments:Faculty of Physiotherapy

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