Abstract

EFFECT OF CHEST PHYSIOTHERAPY ON THE PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA AND MORTALITY

Dr. Arti Yadu M.D.*, Dr. Pankaj Kumar Omar M.D, Dr. Pitamber Patel and Dr. Sushmita Ghosh

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Abstract

Background: Even after a lot of progress that has been achieved in the recent years in the diagnosis, prevention and treatment of ventilatorassociated pneumonia (VAP), it still continues to create complication during the course of treatment in a significant proportion of patients who are mechanically ventilated. Objective: Study was designed to evaluate the effect of multimodality chest physiotherapy in intubated mechanically ventilated patients undergoing treatment in the intensive care units (ICUs) for the prevention of VAP and overall mortality. Patients and Methods: A total of 90 adult intubated and mechanically ventilated patients were included in this study. Manual hyperinflation (MH) and suctioning were administered to patients in the control group (n = 51), and positioning and chest wall vibrations in addition to MH plus suctioning (multimodality chest physiotherapy) were administered to patients in the study group (n = 39) till they were extubated. Both the groups were subjected to treatment twice a day. Standard care in the form of routine nursing care, pharmacological therapy, inhalation therapy, as advised by the concerned physician/surgeon was strictly implemented throughout the intervention period. Results: Data were analyzed using SPSS window version 9.0. The Clinical Pulmonary infection Score (CPIS) Score and VAP showed significant decrease at the end of extubation Although, overall mortality was not different in both the groups. Conclusions: It was observed in this study that twice-daily multimodality chest physiotherapy was associated with a significant decrease in the CPIS Scores and development of VAP. There was no significant reduction in the mortality rates This suggested benefit of physiotherapy in prevention of VAP requires confirmation with a larger randomized controlled trial.

Keywords: Clinical Pulmonary infection Score, multimodality chest physiotherapy, ventilator-associated pneumonia.