The effect of physiotherapy treatment on oxygen consumption and haemodynamics in patients who are critically ill.

Abstract

The purpose of this study was to determine metabolic and haemodynamic changes with and without physiotherapy treatment in haemodynamically stable, intubated and ventilated patients. This was a prospective, randomised cross-over study. Ten intubated, ventilated and haemodynamically stable patients underwent a 20 min physiotherapy treatment and a 20 min period of undisturbed side lying. Mean oxygen consumption (VO2mean) was measured on a minute-to-minute basis by indirect calorimetry. Mean arterial pressure (MAP) was recorded minutely from the indwelling arterial line and cardiac index (CI) was calculated from the indwelling pulmonary artery catheter. Time to recovery to within 5% of resting VO2 was also recorded. The results showed no significant increase in VO2mean with either positioning the patient in side lying or physiotherapy treatment (p = 0.17). Time to recovery to within 5% of baseline VO2 occurred within seven minutes for all patients and there was no significant difference between either physiotherapy treatment or positioning in side lying (p = 0.63). There were no significant differences in CI (p = 0.44) or MAP (p = 0.95) during physiotherapy treatment compared with undisturbed side lying. It is concluded that physiotherapy treatment does not significantly alter VO2mean or MAP and CI in stable intubated and ventilated patients.