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Vol. 23. Issue 4.
Pages 317-323 (01 July 2019)
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Vol. 23. Issue 4.
Pages 317-323 (01 July 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.08.012
Role of physical therapists in the weaning and extubation procedures of pediatric and neonatal intensive care units: a survey
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Suzi Laine Longo dos Santos Baccia, Janser Moura Pereirab, Amanda Cristina da Silva Chagasc, Lais Ribeiro Carvalhoc, Vivian Mara Gonçalves de Oliveira Azevedoc,
Corresponding author
vivian.azevedo@ufu.br

Corresponding author at: Faculdade de Educação Física e Fisioterapia – FAEFI, Rua Benjamin Constant, 1286 Bairro Aparecida, CEP: 38400-678, Uberlândia, MG, Brazil.
a Postgraduate Program in Health Sciences, Medical School, Universidade Federal de Uberlandia (UFU), Uberlandia, MG, Brazil
b Mathematics School, Universidade Federal de Uberlandia (UFU), Uberlandia, MG, Brazil
c Physical Education and Physiotherapy School, Universidade Federal de Uberlandia (UFU), Uberlândia, MG, Brazil
Highlights

  • ICUs using MV weaning protocols frequently had physical therapists perform the procedure.

  • When physical therapists decided on extubation, they were specifically assigned to the ICU.

  • Physical therapists being available 24h/day were associated with successful on the first attempt at extubation.

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Figures (1)
Tables (3)
Table 1. Data related to ICUs answering the study's questions (N=146), regarding MV weaning and extubation procedures/protocols.
Table 2. Comparison between types of ICUs, use of MV weaning protocol and other variables.
Table 3. Comparison of the physical therapist's presence in ICU with the other variables analyzed.
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Abstract
Background

Weaning a patient from mechanical ventilation is a complex procedure that involves clinical and contextual aspects. Mechanical ventilation also depends on the characteristics of health professionals who work in intensive care.

Objective

This study described the organizational aspects associated with the physical therapist's performance in the weaning procedure from mechanical ventilation and extubation in neonatal, pediatric and mixed (neonatal and pediatric) intensive care units in Brazil.

Methods

In order to identify the existing intensive care units in Brazil, data from the National Health Facilities Census was used to enable the researchers to obtain information about registered units. A cross-sectional survey was carried out by sending an electronic questionnaire to 298 neonatal, pediatric and mixed intensive care units in Brazil.

Results

This study assessed questionnaires from 146 intensive care units (49.3% neonatal, 35.6% pediatric and 15.1% mixed). A total of 57.5% of these units applied mechanical ventilation weaning protocols, and a physical therapist frequently conducted this procedure (66.7%). However, the clinician responsible for conducting the weaning and deciding when to do extubation varied regardless of ICU patient age profile. Regardless of the type of hospital or the type of units, most of these had a dedicated physical therapist. However, physical therapy care 24h/7 days per week was predominantly in pediatric intensive care units (56.0%), and in public hospitals (45.9%). Moreover, when the physical therapist was available 24h/7 days per week, (s)he was responsible for the mechanical ventilation extubation decision and patients were successfully extubated on the first attempt.

Conclusion

In this survey, intensive care units using physical therapy assistance 24h/7 days per week were associated with the use of a mechanical ventilation weaning protocol, an extubation decision and success commonly on the first attempt of extubation.

Keywords:
Ventilator weaning
Mechanical ventilation
Physical therapy
Neonate
Pediatric

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