Effect of Multimodality Chest Physiotherapy on Extubation and Critically Ill Mechanically Ventilated Patients Outcomes

Abstract

Background: In the intensive care units’ ICUs, both physiotherapy and extubation are two important and closely related interventions that may enhance the patient’s recovery. study aimed to investigate the effect of multimodality chest physiotherapy on extubation and critically ill mechanically ventilated patients’ outcomes. Subjects and Methods: Quasi-experimental research design was used. Sampling A purposive sample included 100 mechanically ventilated patients taken from respiratory ICU in Aswan University Hospital. Data collection tools: Tool 1, critically ill patient clinical profile was used for collecting data, it included three parts: bio-demographic and clinical data, hemodynamic and respiratory parameters, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scale. Tool2, Chest physiotherapy modalities including its include, inspiratory muscle training (IMT) device, passive, and positive range of motion, and early mobilization in addition to conventional chest physiotherapy. Results: the outcome data among both groups, there were considerable variance regarding the duration of mechanical ventilation (MV), length of ICU stays, negative inspiratory force (NIF), extubation outcome, reintubation, noninvasive ventilation NIV, and mortality rate (P = 0.023, 0.012, 0.045, 0.047, 0.012, 0.021, 0.017 respectively). Moreover, where there was considerable variance between the extubation subcategories among the study group regarding serum potassium, APATCHE II scale, duration of MV, length of ICU stays, and the need for NIV (P= 0.031, 0.002, 0.003, 0.001, 0.000 respectively). Conclusion: The application of Multimodality chest physiotherapy can improve Extubation and patient outcome compared to traditional chest physiotherapy. Recommendation: Nurses and physicians in all ICU could be advised to apply the Multimodality chest physiotherapy in their sitting.