Physiotherapy
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Randomized Controlled Trial
Airflow distribution with manual hyperinflation as assessed through gamma camera imaging: a crossover randomised trial.
Manual hyperinflation (MHI) has been shown to improve lung compliance, reduce airway resistance, and enhance secretion removal and peak expiratory flow. The aims of this study were to investigate whether there is a difference in airflow distribution through patients' lungs when using the Laerdal and Mapleson-C circuits at a set level of positive end-expiratory pressure (PEEP), and to establish whether differences in lung compliance and haemodynamic status exist when patients are treated with both these MHI circuits. ⋯ Airflow distribution through patients' lungs was similar when the Laerdal and Mapleson-C MHI circuits were compared using a set level of PEEP in the supine position.
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Clinical Trial
Implementation of a protocol facilitates evidence-based physiotherapy practice in intensive care units.
To compare the physiotherapy service provided when therapists' decisions are guided by an evidence-based protocol with usual care (i.e. patient management based on therapists' clinical decisions). ⋯ Physiotherapy services provided in intensive care units (ICUs) when the decisions of non-specialised therapists are guided by an evidence-based protocol are safe, differ from usual care, and reflect international consensus on current best evidence for physiotherapy in ICUs. Non-specialised therapists can use this protocol to provide evidence-based physiotherapy services to their patients. Future trials are needed to establish whether or not this will improve patient outcome.
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Observational Study
Association of postoperative pulmonary complications with delayed mobilisation following major abdominal surgery: an observational cohort study.
Previous Australian studies reported that postoperative pulmonary complications affect 13% of patients undergoing upper abdominal laparotomy. This study measured the incidence of postoperative pulmonary complications, risk factors for the diagnosis of postoperative pulmonary complications and barriers to physiotherapy mobilisation in a cohort of patients undergoing high-risk abdominal surgery. ⋯ This study demonstrated an association between delayed postoperative mobilisation and postoperative pulmonary complications. Randomised controlled trials are required to test the role of early mobilisation in preventing postoperative pulmonary complications in patients undergoing high-risk upper abdominal surgery.