» Articles » PMID: 28203436

Chest Physiotherapy in Mechanically Ventilated Patients Without Pneumonia-a Narrative Review

Overview
Journal J Thorac Dis
Specialty Pulmonary Medicine
Date 2017 Feb 17
PMID 28203436
Citations 12
Authors
Affiliations
Soon will be listed here.
Abstract

A beneficial adjuvant role of chest physiotherapy (CPT) to promote airway clearance, alveolar recruitment, and ventilation/perfusion matching in mechanically ventilated (MV) patients with pneumonia or relapsing lung atelectasis is commonly accepted. However, doubt prevails regarding the usefulness of applying routine CPT in MV subjects with no such lung diseases. In-depth narrative review based on a literature search for prospective randomized trials comparing CPT with a non-CPT strategy in adult patients ventilated for at least 48 h. Six relevant studies were identified. Sample size was small. Various CPT modalities were used including body positioning, manual chest manipulation (mobilization, percussion, vibration, and compression), and specific techniques such as lung hyperinflation and intrapulmonary percussion. Control subjects mostly received general nursing care and tracheal suction. In general, CPT was safe and supportive, yet had debatable or no significant impact on any relevant patient outcome parameter, including pneumonia. Current evidence does not support "prophylactic" CPT in adult MV patients without pneumonia.

Citing Articles

Integral Role of Chest Physiotherapy and Proprioceptive Neuromuscular Facilitation in Improving the Oxygenation Index and Quality of Life of Patients With Squamous Cell Carcinoma: A Case Report.

Aherrao S, Lalwani L Cureus. 2025; 17(1):e78009.

PMID: 40007924 PMC: 11855806. DOI: 10.7759/cureus.78009.


Nursing Process Related to the Nursing Focus "Airway Clearance": A Scoping Review.

Gaspar L, Reis N, Sousa P, Silva A, Cardoso A, Brito A Nurs Rep. 2024; 14(3):1871-1896.

PMID: 39189270 PMC: 11348224. DOI: 10.3390/nursrep14030140.


Novelty of Physiotherapy Management in a Classic Case of Chronic Obstructive Pulmonary Disease in an 84-Year-Old Male Patient with Hypertension and Well-Controlled Hypothyroidism: A Case Report.

Nangliya R, Yadav V, Nandanwar S Cureus. 2024; 16(3):e57318.

PMID: 38690482 PMC: 11060019. DOI: 10.7759/cureus.57318.


Systemic and Cerebral Effects of Physiotherapy in Mechanically Ventilated Subjects.

Battaglini D, Ciaravolo E, Caiffa S, Delpiano L, Ball L, Vena A Respir Care. 2023; 68(4):452-461.

PMID: 36810363 PMC: 10173117. DOI: 10.4187/respcare.10227.


A deep look into the rib cage compression technique in mechanically ventilated patients: a narrative review.

Jalil Y, Damiani L, Basoalto R, Bachmman M, Bruhn A Rev Bras Ter Intensiva. 2022; 34(1):176-184.

PMID: 35766667 PMC: 9345587. DOI: 10.5935/0103-507X.20220012-pt.


References
1.
Marti J, Li Bassi G, Rigol M, Saucedo L, Ranzani O, Esperatti M . Effects of manual rib cage compressions on expiratory flow and mucus clearance during mechanical ventilation. Crit Care Med. 2013; 41(3):850-6. DOI: 10.1097/CCM.0b013e3182711b52. View

2.
Ntoumenopoulos G, Presneill J, McElholum M, Cade J . Chest physiotherapy for the prevention of ventilator-associated pneumonia. Intensive Care Med. 2002; 28(7):850-6. DOI: 10.1007/s00134-002-1342-2. View

3.
Templeton M, Palazzo M . Chest physiotherapy prolongs duration of ventilation in the critically ill ventilated for more than 48 hours. Intensive Care Med. 2007; 33(11):1938-45. DOI: 10.1007/s00134-007-0762-4. View

4.
Clini E, Degli Antoni F, Vitacca M, Crisafulli E, Paneroni M, Chezzi-Silva S . Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med. 2006; 32(12):1994-2001. DOI: 10.1007/s00134-006-0427-8. View

5.
Magill S, Klompas M, Balk R, Burns S, Deutschman C, Diekema D . Developing a new, national approach to surveillance for ventilator-associated events*. Crit Care Med. 2013; 41(11):2467-75. PMC: 10847970. DOI: 10.1097/CCM.0b013e3182a262db. View