Patman S, Jenkins S, Stiller K.
This study was designed to determine whether, regular respiratory physiotherapy in mechanically ventilated patients with acquired brain injury (ABI), prevented ventilator-associated pneumonia (VAP), reduce length of mechanical ventilation or ICU stay. One hundred and forty-four subjects with acquired brain injury, a Glasgow Coma Scale ?9, requiring intracranial pressure monitoring, and invasive mechanical ventilation (MV) for >24 h were included in the study, of these 33 subjects were subsequently diagnosed with (VAP). Respiratory physiotherapy comprised six treatments (positioning, manual hyperinflation and suctioning) in each 24-h period whilst on MV. The Control Group received standard medical/nursing care but no respiratory physiotherapy.
The results showed that in adults with ABI, regular respiratory physiotherapy in addition to routine medical/nursing care does not appear to prevent VAP, reduce length of MV or ICU stay. Due to small numbers, it is not possible to draw any conclusions as to whether or not respiratory physiotherapy hastens recovery from VAP.
Intensive Care Medicine 2009; 35: 258 â€“ 265