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Semin Respir Crit Care Med 2020; 41(06): 886-898
DOI: 10.1055/s-0040-1709139
Review Article

Physical Therapy and Rehabilitation in Chronic Obstructive Pulmonary Disease Patients Admitted to the Intensive Care Unit

Joan Daniel Martí
1   Cardiovascular Surgery Intensive Care Unit, Hospital Clínic de Barcelona, Spain
,
David McWilliams
2   Therapy Services, University Hospitals Birmingham NHS Foundation Trust, United Kingdom
,
Elena Gimeno-Santos
3   Respiratory Department, Hospital Clinic de Barcelona, Spain
4   August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition that affects a person's ability to exercise and undertake normal physical function due to breathlessness, poor physical fitness, and muscle fatigue. Patients with COPD often experience exacerbations due to pulmonary infections, which result in worsening of their symptoms, more loss of function, and often require hospital treatment or in severe cases admission to intensive care units. Recovery from such exacerbations is often slow, and some patients never fully return to their previous level of activity. This can lead to permanent disability and premature death.

Physical therapists play a key role in the respiratory management and rehabilitation of patients admitted to intensive care following acute exacerbation of COPD. This article discusses the key considerations for respiratory management of patients requiring invasive mechanical ventilation, providing an evidence-based summary of commonly used interventions. It will also explore the evidence to support the introduction of early and structured programs of rehabilitation to support recovery in both the short and the long term, as well as active mobilization, which includes strategies to minimize or prevent physical loss through early retraining of both peripheral and respiratory muscles.

Keywords

COPD - intensive care unit - mechanical ventilation - respiratory physical therapy - muscle training - early mobilization


Publication History

Article published online:
28 July 2020

© 2020. Thieme. All rights reserved.

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