Settings and monitoring of mechanical ventilation during physical therapy in adult critically ill patients: protocol for a scoping review

Journal
BMJ Open
ISSN
2044-6055
2044-6055
Date Issued
2019
Author(s)
Anita Jasmén Sepúlveda
Jorge Molina Blamey
Type
Resource Types::text::journal::journal article
Scopus ID
2-s2.0-85071613769
WoS ID
WOS:000502537200359
DOI
URL
URL Institutional Repository
Abstract
<jats:sec><jats:title>Introduction</jats:title><jats:p>Early mobilisation has been extensively advocated to improve functional outcomes in critically ill patients, even though consistent evidence of its benefits has remained elusive. These conflicting results could be explained by a lack of knowledge on the optimal dosage of physical therapy and a mismatch between ventilatory support and exercise-induced patient ventilatory demand. Modern mechanical ventilators provide real-time monitoring of respiratory/metabolic variables and ventilatory setting that could be used for physical therapy dosage or ventilatory support titration, allowing individualised interventions in these patients. The aim of this review is to comprehensively map and summarise current knowledge on adjustments of respiratory support and respiratory or metabolic monitoring during physical therapy in adult critically ill mechanically ventilated patients.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>This is a scoping review protocol based on the methodology of the Joanna-Briggs-Institute. The search strategy will be conducted from inception to 30 June 2019 as a cut-off date in PubMed, CINAHL, Rehabilitation & Sport Medicine, Scielo Citation Index, Epistemónikos, Clinical Trials, PEDro and Cochrane Library, performed by a biomedical librarian and two critical care physiotherapists. All types of articles will be selected, including conference abstracts, clinical practice guidelines and expert recommendations. Bibliometric variables, patient characteristics, physical therapy interventions, ventilator settings and respiratory or metabolic monitoring will be extracted. The identified literature will be analysed by four critical care physiotherapists and reviewed by a senior critical care physician.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>Ethical approval is not required. The knowledge-translation of the results will be carried out based on the End-of-Grant strategies: diffusion, dissemination and application. The results will be published in a peer-review journal, presentations will be disseminated in relevant congresses, and recommendations based on the results will be developed through training for mechanical ventilation and physical therapy stakeholders.</jats:p></jats:sec>
Subjects
mechanical ventilation

; 

physical therapy modalities

; 

exercise

; 

early mobilisation

; 

intensive care units

; 

adult

; 

critical care

; 

critical illness

; 

evidence-based medicine

; 

humans

; 

intensive care units

; 

physical therapy modalities

; 

respiration, artificial

; 

ventilator weaning

; 

adult

; 

artificial ventilation

; 

assisted ventilation

; 

cinahl

; 

clinical trial (topic)

; 

cochrane library

; 

critically ill patient

; 

diffusion

; 

exercise

; 

female

; 

human

; 

intensive care unit

; 

librarian

; 

male

; 

medline

; 

mobilization

; 

organization

; 

pedro

; 

peer review

; 

physician

; 

physiotherapist

; 

physiotherapy

; 

practice guideline

; 

review

; 

sports medicine

; 

systematic review

; 

ventilated patient

; 

artificial ventilation

; 

critical illness

; 

evidence based medicine

; 

intensive care

; 

intensive care unit

; 

physiotherapy

; 

ventilator weaning