Cardiopulmonary responses to neurophysiological facilitation of respiration in mechanically ventilated ICU patients

Mechanical ventilation is essential in acute illness but may lead to complications such as atelectasis and monotonous breathing, which physiotherapists help counter by using neurophysiological facilitation techniques to enhance the respiratory function of unconscious and sedated patients. By exploring neurophysiological facilitation techniques, the study aimed to evaluate the immediate effects of perioral pressure and intercostal stretch on cardiopulmonary parameters in mechanically ventilated patients at the University of Benin Teaching Hospital. A randomised crossover experimental design was used, involving ten patients (5 males, 5 females; mean age 66.2 ± 8.5 years) who were haemodynamically stable but unconscious and ventilated. Cardiopulmonary variables including systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, oxygen saturation, and mean arterial pressure were measured before and after each neurophysiological facilitation techniques intervention using a standardised protocol. The results showed that perioral pressure significantly improved diastolic blood pressure (77.10±9.01 to 79.30±10.34 mmHg, p=0.005), respiratory rate (26.40 ± 6.08 to 28.30 ± 6.60 breaths/min, p = 0.014), and mean arterial pressure (92.70 ± 10.70 to 94.00 ± 10.06 mmHg, p = 0.022). Intercostal stretch significantly increased respiratory rate (26.8 ± 6.07 to 28.2 ± 6.07 breaths/min, p < 0.001), while changes in systolic pressure, heart rate, and oxygen saturation were not statistically significant (p>0.05). Gender did not influence the magnitude of changes in any cardiopulmonary parameter. The study established that neurophysiological facilitation techniques elicited beneficial acute effects on respiratory rate and haemodynamic parameters in mechanically ventilated patients and highlighted neurophysiological facilitation techniques as a practical adjunct to respiratory physiotherapy for improved cardiopulmonary stability in critically ill patients

haemodynamic parameters; perioral pressure; intercostal stretch; respiratory therapy intervention; intensive care physiotherapy

https://doi.org/10.63341/ijmmr/1.2026.14
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