Physiotherapy practice patterns for acute respiratory distress syndrome in intensive care unit in India - A survey

Objective: To determine the practice patterns of physiotherapists for acute respiratory distress syndrome (ARDS) in the Intensive care unit in India. Materials and methods: A cross sectional survey was conducted across India, in which 600 questionnaires were sent via email to cardio-pulmonary physiotherapists. The questionnaire addressed assessment and treatment techniques of ventilated and non-ventilated ARDS patients. Results: A total of 252 completed questionnaires were returned with a response rate of 42%. The assessment and treatment techniques used were almost similar for ventilated and non-ventilated patients. More than 75% of the responders monitored vital and ventilatory parameters and respiratory impairments for both ventilated and non-ventilated patients. An objective measure of dyspnea was taken by less than 70% responders with minimal attention given to functional exercise capacity, measures of function and health related quality of life measures. Supine Positioning (81.7%)was used more in ventilated patients whereas upright position (75%) was used more in non-ventilated patients. 75% of responders use secretion clearance and manual techniques for both ventilated and non-ventilated patients. In non-ventilated patients, breathing strategies were used by 85% responders, 86.1% performed ambulation and more than 60% physiotherapists used strength training. Conclusion: Assessment predominately focuses on monitoring vital signs and ventilator parameters, and taking impairment measures for ventilated and non-ventilated patients, with little attention given to functional exercise capacity, measures of function and health related quality of life measures. Treatment predominately focuses on body positioning, airway clearance techniques, manual techniques and range of motion exercises for ventilated patients and in addition to all aforementioned breathing strategies and functional training for non-ventilated patients.