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Published on: November 26, 2018
Acute Hemodynamic Changes Induced by Physiotherapy in Critically Ill Patients: A Prospective Observational Study
K J Priyanka1, Dipali A Taggarsi1, Bhuvana Krishna1
1Department of Critical Care Medicine, St John's Medical College Hospital, Bengaluru, Karnataka, India.
Physiotherapy is safe for critically ill patients, even those on vasopressors. Minor hemodynamic changes during therapy are not clinically significant, indicating good tolerance and low adverse event rates.
Area of Science:
- Critical care medicine
- Physiotherapy
- Hemodynamics
Background:
- Physiotherapy offers significant benefits for critically ill patients.
- Limited data exists on the safety of physiotherapy concerning hemodynamic changes, especially with vasopressor use.
Purpose of the Study:
- To evaluate the safety and hemodynamic effects of physiotherapy in critically ill patients.
- To determine the level of vasopressor support at which physiotherapy can be safely administered.
Main Methods:
- 107 critically ill patients underwent physiotherapy (active or passive).
- Hemodynamic parameters (cardiac output, blood pressure, heart rate, SpO2) were monitored before, during, and after physiotherapy.
- Adverse events were recorded.
Main Results:
- Transient, statistically significant increases in heart rate, respiratory rate, blood pressure, and cardiac output were observed post-physiotherapy.
- These hemodynamic changes were deemed clinically insignificant.
- The incidence of adverse events was low at 10.2%.
Conclusions:
- Physiotherapy is well-tolerated in critically ill patients, including those requiring vasopressors.
- Observed hemodynamic fluctuations are likely physiological responses to increased oxygen demand.
- Low adverse event rates confirm the safety of physiotherapy in the intensive care unit (ICU).
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