Effects of structured protocolized physical therapy on the duration of mechanical ventilation in patients with prolonged weaning

Bickenbach, Johannes; Cosler, Sophia; Fritsch, Sebastian; Kao, Joyce; Dreher, Michael; Hildebrand, Frank; Simon, Tim Philipp; Simon, Yvonne; Marx, Gernot; Theisen, Silke

doi:10.1016/j.jcrc.2023.154491

Journal Article

FZJ-2024-01859

Effects of structured protocolized physical therapy on the duration of mechanical ventilation in patients with prolonged weaning

Bickenbach, J. (Corresponding author) ; Fritsch, S.FZJ* ; Cosler, S. ; Simon, Y. ; Dreher, M. ; Theisen, S. ; Kao, J. ; Hildebrand, F. ; Marx, G. ; Simon, T. P.

2024
Elsevier Amsterdam

Journal of critical care 80, 154491 (2024) [10.1016/j.jcrc.2023.154491]

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Please use a persistent id in citations: doi:10.1016/j.jcrc.2023.154491 doi:10.34734/FZJ-2024-01859

Abstract: Purpose20% of patients with mechanical ventilation (MV) have a prolonged, complex weaning process, often experiencing a condition of ICU-acquired weakness (ICUAW), with a severe decrease in muscle function and restricted long-term prognosis. We aimed to analyze a protocolized, systematic approach of physiotherapy in prolonged weaning patients and hypothesized that the duration of weaning from MV would be shortened.MethodsICU patients with prolonged weaning were included before (group 1) and after (group 2) introduction of a quality control measure of a structured and protocolized physiotherapy program. Primary endpoint was the tested dynamometric handgrip strength and the Surgical Intensive Care Unit Optimal Mobilization Score (SOMS). Secondary endpoints were weaning success rate, ventilator-free days, hospital mortality, the prevalence of ICUAW, infections and delirium.Results106 patients were included. Both the SOMS and the handgrip test were significantly improved after introducing the program. Despite no differences in weaning success rates at discharge, the total length of MV was significantly shorter in group 2, which also had lower prevalence of infection and higher probability of survival.ConclusionsProtocolized, systematic physiotherapy resulted in an improvement of the clinical outcome in patients with prolonged weaning. Results were objectifiable with the SOMS and the handgrip test.

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