What is the role of the physiotherapist in paediatric intensive care units? A systematic review of the evidence for respiratory and rehabilitation interventions for mechanically ventilated patients

Hawkins, Ellie, and Jones, Anne (2015) What is the role of the physiotherapist in paediatric intensive care units? A systematic review of the evidence for respiratory and rehabilitation interventions for mechanically ventilated patients. Physiotherapy, 101 (4). pp. 303-309.

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Abstract

Background: Physiotherapy in intensive care units (ICU) has traditionally focussed on the respiratory management of mechanically ventilated patients. Gradually, focus has shifted to include rehabilitation in adult ICUs, though evidence of a similar shift in the paediatric ICU (PICU) is limited.

Objectives: Review the evidence to determine the role of physiotherapists in the management of mechanically ventilated patients in PICU.

Data sources: A search was conducted of: PEDro, CINAHL, Medline, PubMed and the Cochrane Library.

Eligibility criteria: Studies involving PICU patients who received physiotherapy while invasively ventilated were included in this review. Those involving neonatal or adult ICU patients, or patients on non-invasive or long-term ventilation, were not included in the study.

Study appraisal: All articles were critically appraised by two reviewers and results were analysed descriptively.

Results: Six studies on chest physiotherapy (CPT) met the selection criteria. Results support the use of the expiratory flow increase technique and CPT, especially manual hyperinflation and vibrations, for secretion clearance. Evidence does not support the routine use of either CPT or suction alone. No studies investigating rehabilitation in PICU met selection criteria.

Limitations: A lack of high level evidence was available to inform this review.

Conclusion: Evidence indicates that CPT is still the focus of physiotherapy intervention in PICU for mechanically ventilated patients, and supports its use for secretion clearance in this setting.

Item ID: 41864
Item Type: Article (Research - C1)
ISSN: 1873-1465
Keywords: intensive care, pediatrics, physical therapy specialty, physical therapists, ventilators, mechanical
Date Deposited: 08 Dec 2015 16:57
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 80%
11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111403 Paediatrics @ 20%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 90%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 10%
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