THE PHYSIOTHERAPIST'S ROLE IN INTENSIVE CARE PEDIATRICS, A REVIEW OF THE EVIDENCE SUPPORTING MECHANICALLY VENTILATED PATIENTS RESPIRATORY AND REHABILITATION INTERVENTIONS

Abstract

Background: In the Pediatric ICUs, many of the children are ventilated and this creates issues such as breathing difficulties and excessive stays on the immobile bed. Physiotherapists contribute a lot to the treatment of such patients and not much concrete evidence supports their actions. Objective: I needed to know what physiotherapists actually do with kids on ventilators in the PICU and particularly with regard to breathing and rehabilitation. Methods: I was using PubMed, Google Scholar, Scopus, PEDro database. The search keywords were such terms as intensive care, pediatrics, physical therapy specialty, physical therapists, ventilators and mechanical. Papers in English were only retained that discussed kids on invasive ventilators within the PICU that received PT. I excluded articles on adults or neonates or non-invasive ventilation. Following a three-step filtering, five articles remained to undergo last review. Findings: The articles indicated that such treatments as chest physiotherapy (CPT), manual hyperinflation (MHI), vibrations, saline swaps, and tube cleaning (ETT suction) were prevalent. Peak expiratory flow and tidal volumes appeared to be raised by MHI and vibrations. ETT suction assisted partially in lung performance and other times led to slight oxygen decline and slow cardiac rhythm. Expiratory flow increases technique (EFIT) was useful in delivering oxygen with no significant drawbacks. CPT also increased the volume of lung air in the lungs. Conclusion: PICUs cannot become without physiotherapists who are needed to get the kids on ventilators breathing and moving once again. CT can be beneficial to the breathing but one should monitor any side effects. More large-sized research involving standardized methods of doing things would really be needed to validate these results and inform day-to-day practice.