Physiotherapy in intensive care is safe: an observational study

Aust J Physiother. 2007;53(4):279-83. doi: 10.1016/s0004-9514(07)70009-0.

Abstract

Question: How often do adverse events (including adverse physiological changes) occur during physiotherapy intervention in intensive care?

Design: A multi-centre prospective observational study.

Participants: Five tertiary level university-affiliated intensive care units.

Outcome measures: All physiotherapy intervention in five intensive care units over a three month period. When certain specified changes occurred during physiotherapy intervention, details were noted including diagnosis of patient, intervention, vital signs, radiological changes, co-morbidities, chemical pathology, and fluid balance.

Results: 12 281 physiotherapy interventions were completed with 27 interventions resulting in adverse physiological changes (0.2%). This incidence was significantly lower than a previous study of adverse physiological changes (663 events in 247 patients over a 24-hour period); the incidence during physiotherapy intervention was lower than during general intensive care. Common factors in the patients who had an adverse physiological change were a deterioration in cardiovascular status (ie, decrease in blood pressure or arrhythmia) in patients on medium to high doses of inotropes/vasopressors, unstable baseline hemodynamic values, previous cardiac co-morbidities and intervention consisting of positive pressure or right side lying.

Conclusion: The incidence of adverse events during physiotherapy intervention in these five tertiary hospitals was low, demonstrating that physiotherapy intervention in intensive care is safe.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / etiology
  • Clinical Audit*
  • Critical Care / methods*
  • Critical Illness / therapy*
  • Female
  • Humans
  • Hypertension / etiology
  • Incidence
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Physical Therapy Modalities / adverse effects*
  • Prospective Studies
  • Task Performance and Analysis