Brief research report 85 The effect of physiotherapy on ventilatory dependency and the length of stay in an intensive care unit Mehtap Malkoc ¸, Didem Karadibak and Yu ¨ cel Yıldırım The aim of this study was to assess the effect of physiotherapy on ventilator dependency and lengths of intensive care unit (ICU) stay. Patients were divided into two groups. The control group, which received standard nursing care, was a retrospective chart review. The data of control patients who were not receiving physiotherapy were obtained from the hospital records. The intervention group was prospectively taken into the chest physiotherapy program. This study was planned on mechanically ventilated patients who were admitted to a six-bed multidisciplinary internal medicine intensive care unit of the university hospital. A total of 510 patients who were hospitalised in the ICU were included in the study. Demographics, diagnostic profiles, co-existing chronic diseases, respiratory parameters on admission, patient’s overall severity by Acute Physiology and Chronic Health Evaluation II score, patient outcome, duration of stay in ICU, duration of ventilator support, and complications were assessed. The extubation time and length of ICU stay were compared between the two groups. Control patients had a longer period of ventilator dependency than the intervention patients and this difference was statistically significant (P < 0.05). It was noted that the resulting length of stay in the ICU was significantly lower in the intervention group than in the control group (P < 0.05). Although the patients had similar diagnoses and physical features, the length of stay in the ICU was significantly lower in the intervention group. The results show that physiotherapy has a great impact on ventilatory dependency and length of stay in the ICU. International Journal of Rehabilitation Research 32:85–88  c 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins. International Journal of Rehabilitation Research 2009, 32:85–88 Keywords: mechanical ventilation, physiotherapy, respiratory insufficiency School of Physical Therapy and Rehabilitation, Dokuz Eylu ¨ l University, Inciraltı/I ˙ zmir, Turkey Correspondence to Didem Karadibak, PhD, PT, School of Physical Therapy and Rehabilitation, Dokuz Eylu ¨ l University, 35340 Inciraltı/I ˙ zmir, Turkey Tel: +90 232 412 49 41; fax: +90 232 277 50 30; e-mail: didem.karadibak@gmail.com; yuzbasioglu@deu.edu.tr Received 13 June 2007 Accepted 10 October 2007 Introduction Physiotherapy may be applied for patients in the intensive care setting when they have retained secretions and radiological evidence of atelectasis or infiltration, or as prophylaxis in conditions such as acute head injury and smoke inhalation (Stiller, 2000; Buhop, 1996). Physio- therapy interventions include postural drainage, breathing, huffing and suction. Body positioning, which primarily aims at optimizing ventilation–perfusion ratios, and mobilization and exercise are physiotherapy interventions not traditionally considered as part of the treatment for these patients (Kendall and Jockson, 1987; Buhop, 1996; Ciesta, 1996; Bawton, 1999). Dean, on the basis of extensive reviews of physiological evidence, concluded that body positioning and mobilization and exercises should be the first-line interventions for patients with cardiopulmonary system dysfunctions. Few studies have examined the effectiveness of physiotherapy interven- tions for patients who are critically ill and in intensive care units (ICUs) (Buhop, 1996; Ciesta, 1996; Stiller, 2000). The short-term physiotherapy goal was to reduce the gas exchange impairment by optimizing the ventilation– perfusion ratio, decreasing the patients’ effort in breathing, instructing them in effective coughing or huffing, removing or facilitating the removal of secretions and educating them in self-administered bronchial hygiene. The long-term goals, when the patient became less dyspneic, were to assess and improve exercise tolerance and to facilitate independent management of dyspnea and bronchial hygiene (Kendall and Jockson, 1987; Buhop, 1996; Ciesta, 1996; Nova, 1998; Stiller, 2000). The purpose of this study was to evaluate the effect of physiotherapy on ventilator dependency and lengths of ICU stay. Methods Participants This study was planned on mechanically ventilated patients who were admitted to a six-bed, multidiscipli- nary internal medicine intensive care unit of the university hospital. Exclusion criteria included acute respiratory distress syndrome, acute pulmonary edema, acute head injury, MAP less than 60 mmHg, peak inspiratory airway pressure over 40 cm H 2 O (as recorded from the ventilator), 0342-5282  c 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI: 10.1097/MRR.0b013e3282fc0fce Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.