Chest physiotherapy practice in intensive care units in Australia, the UK and Hong Kong

Abstract

IA questionnaire was sent to 34 hospitals in Australia, 33 in the UK a n d 1 1 in HongKong to investigate current physiotherapy work practices in intensive care units (ICUs). T h e questionnaires were returned from 32 hospitals in Australia, 21 in the UK and 9 in Hong Kong, giving a response rate of 94, 64 a n d 82% respectively.A 24-hour on-call physiotherapy service was available in 97% of the ICUs surveyed in the UK; however, this service was available in only 49% of the units in Australia and none of the ICUs in Hong Kong. Referral decisions were purely the verdict of the physiotherapist in 31% of the units in the UK and 27% of the units in Australia. This form of referral system, however, does not exist in H o n g Kong. A physiotherapist's opinion was sought by medical staff in over 60% of the units in all three countries. suctioning and vibration. Physiotherapists are more scientifically orientated in the UK and Australia -28% of the units surveyed in the UK and 10% in Australia were involved in chest physiotherapy research. H o n g Kong is o u t of step with other countries in this respect.T h e most commonly used techniques employed in all three countries were I

Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model

“…In a series of experiments on high-frequency oscillation applied to dog chest wall, mechanical vibration at rates of [11][12][13][14][15] Hz has been shown to enhance both tracheal and peripheral mucus transport rates in dogs, reaching three times the control group's mucus transport rate at 13 Hz (8,17,26). Enhanced tracheal mucus transport rate at 5 and 8 Hz, but not at 3 Hz, was also noted, although not as remarkable as at higher rates (17).…”

Cardiovascular responses to manual hyperinflation in post-operative coronary artery surgery patients

“…The aim of manual hyperinflation is to improve gas exchange by enhancing collateral ventilation, reducing atelectasis, mobilising pulmonary secretions and improving arterial oxygenation while the patient is still intubated. Despite the widespread use of manual hyperinflation by physiotherapists in intensive care units (King and Morrell, 1992;Jones, Hutchinson and Oh, 1992), the haemodynamic effects of manual hyperinflation in CAS patients are not well documented, although facilities are available to monitor cardiovascular function at the bedside via the use of Swan-Ganz catheters.…”

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

“…The most common techniques used by chest physiotherapists in the ICU are positioning, mobilization, manual hyperinflation (MH), percussion, chest vibrations, suction, cough techniques, and various breathing exercises. [2][3][4][5][6][7][8] A combination of these techniques is used by some physiotherapists in ICU regardless of the patients' underlying patho-physiological condition, with intention of preventing complications, whereas other physiotherapists use such techniques selectively when they believe they are specifically indicated.…”