An Experimental Pre-Post Study on the Efficacy of Respiratory Physiotherapy in Severe Critically III COVID-19 Patients

Denise Battaglini; Salvatore Caiffa; Giovanni Gasti; Elena Ciaravolo; Chiara Robba; Jacob Herrmann; Sarah E. Gerard; Matteo Bassetti; Paolo Pelosi; Lorenzo Ball; GECOVID (GEnoa COVID-19) group

doi:10.3390/jcm10102139

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An Experimental Pre-Post Study on the Efficacy of Respiratory Physiotherapy in Severe Critically III COVID-19 Patients

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An Experimental Pre-Post Study on the Efficacy of Respiratory Physiotherapy in Severe Critically III COVID-19 Patients

Denise Battaglini, Salvatore Caiffa, Giovanni Gasti, Elena Ciaravolo, Chiara Robba, Jacob Herrmann, Sarah E. Gerard, Matteo Bassetti, Paolo Pelosi, Lorenzo Ball, …

Journal of clinical medicine, Vol.10(10), p.2139

05/15/2021

DOI: 10.3390/jcm10102139

PMCID: PMC8156952

PMID: 34063429

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Abstract

Background : Respiratory physiotherapy (RPT) is considered essential in patients’ management during intensive care unit (ICU) stay. The role of RPT in critically ill COVID-19 patients is poorly described. We aimed to investigate the effects of RPT on oxygenation and lung aeration in critically ill COVID-19 patients admitted to the ICU. Methods : Observational pre-post study. Patients with severe COVID-19 admitted to the ICU, who received a protocolized CPT session and for which a pre-and post-RPT lung ultrasound (LUS) was performed, were included. A subgroup of patients had an available quantitative computed tomography (CT) scan performed within 4 days from RPT. The primary aim was to evaluate whether RPT improved oxygenation; secondary aims included correlations between LUS, CT and response to RPT. Results : Twenty patients were included. The median (1st–3rd quartile) PaO 2 /FiO 2 was 181 (105–456), 244 (137–497) and 246 (137–482) at baseline (T0), after RPT (T1), and after 6 h (T2), respectively. PaO 2 /FiO 2 improved throughout the study ( p = 0.042); particularly, PaO 2 /FiO 2 improved at T1 in respect to T0 ( p = 0.011), remaining higher at T2 ( p = 0.007) compared to T0. Correlations between LUS, volume of gas (rho = 0.58, 95%CI 0.05–0.85, p = 0.033) and hyper-aerated mass at CT scan (rho = 0.54, 95% CI 0.00–0.84, p = 0.045) were detected. No significant changes in LUS score were observed before and after RPT. Conclusions : RPT improved oxygenation and the improvement persisted after 6 h. Oxygenation improvement was not reflected by aeration changes assessed with LUS. Further studies are warranted to assess the efficacy of RPT in COVID-19 ICU patients.

chest physiotherapy

COVID-19

intensive care unit

lung ultrasound

rehabilitation

respiratory physiotherapy

SARS-CoV-2

Details

Title: Subtitle: An Experimental Pre-Post Study on the Efficacy of Respiratory Physiotherapy in Severe Critically III COVID-19 Patients
Creators: Denise Battaglini - Ospedale Policlinico San Martino
Salvatore Caiffa - Ospedale Policlinico San Martino
Giovanni Gasti - University of Genoa
Elena Ciaravolo - University of Genoa
Chiara Robba
Jacob Herrmann - Boston University
Sarah E. Gerard - University of Iowa
Matteo Bassetti - Ospedale Policlinico San Martino
Paolo Pelosi - University of Genoa
Lorenzo Ball - University of Genoa
GECOVID (GEnoa COVID-19) group
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.10(10), p.2139
DOI: 10.3390/jcm10102139
PMID: 34063429
PMCID: PMC8156952
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: MDPI
Language: English
Date published: 05/15/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering
Record Identifier: 9984306747602771

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